A Newer Surgical Approach in Managing a Rare Case of Brown’s Syndrome with Exotropia

Browns syndrome is a restrictive ocular motility disorder characterized by restricted elevation in adduction due to an abnormality of the superior oblique tendon. It can be congenital or acquired. Congenital Brown’s syndrome can be associated with horizontal deviation, which needs correction during surgery. This is a rare case of congenital Brown’s syndrome with a large exotropia in the left eye. In a single sitting, hang-back loop tenotomy of the superior oblique tendon, along with lateral rectus recession, medial rectus resection with true transplantation was done. This procedure corrected vertical and horizontal deviation in a single surgery with optimal outcome.