What is the treatment for Brown syndrome in children?

Brown syndrome is caused by an abnormality of the tendon or trochlea of the superior oblique muscle. This structure is located in the upper-inner corner of the orbit and results in a reduced ability of the patient to elevate her eye, especially when looking up and toward the nose with the affected eye. Brown syndrome is infrequent, though not rare. Treatment options range from observation to surgery. Surgery is the most common method of managing the problem and is the only possible solution in most cases. Surgery is generally indicated when the child exhibits frequent use of an abnormal head posture during visual activities or fails to fuse (use the eyes together). Surgical options include a silicone extender (often referred to as a silicone spacer), a tenotomy (transection) of the superior oblique tendon, tenectomy (removal of a segment) of the superior oblique tendon, and other less frequently used options. Surgery is typically successful in improving or correcting the problem.