Brown’s syndrome during pregnancy: a case report
Brown’s syndrome is an uncommon strabismus characterized by restriction of elevation in adduction and can be congenital or acquired. Clinical features include mild impaired elevation on upgaze, minimal/no elevation deficit on abduction, and minimal/no superior oblique overaction.

The present case has been reported in the Canadian Journal of Ophthalmology. A 34-year-old pregnant female presented to the emergency eye clinic with sudden-onset binocular vertical diplopia upon wakening with isolated right eye pain the previous day. She was 33 weeks pregnant with her second child.

On examination, visual acuity was 20/20 OU. Pupils were equal and reactive to light, with normal intraocular pressures. Ocular motility examination showed an elevation deficit OD in straight up gaze, −4 elevation deficit on adduction OD, and a slight right hypotropia in primary gaze and no compensatory head tilt. There was point tenderness over the right trochlea. Forced ductions showed marked restriction to elevation in adduction OD. Cranial nerves 2, 3, and 5–12 were intact bilaterally. Anterior and posterior segments were normal OU with no proptosis or palpable mass.

She was diagnosed with acute-onset right Brown’s syndrome of unknown etiology. After discussing treatment options with the patient and her obstetrician, a peritrochlear triamcinolone injection 10 mg was administered with no complications.

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