Clinical progression of untreated bilateral Brown syndrome.
OBJECTIVE
To present the natural history of bilateral Brown syndrome in patients without surgical intervention.


METHODS
The medical records of cases of bilateral Brown syndrome not treated surgically with long-term follow-up from 1987 to 2012 were retrospectively reviewed.


RESULTS
A total of 9 cases were included. The majority of patients in this series had idiopathic Brown syndrome, were diagnosed in early childhood, and had minimal ophthalmic sequelae. Of the 9 patients, 8 were diagnosed with bilateral Brown syndrome at their first ophthalmologic assessment. The age range at first diagnosis was 3-6 years of age. The mean follow-up period was 7.9 years; the median, 5 years (range, 1-20 years). At the most recent follow-up visit, 6 patients remained orthophoric in primary position; 1 patient had a micro-esotropia; 1 had developed an exotropia of 30 D; and 1 had developed a right hyperphoria. All patients without concurrent horizontal strabismus developed normal stereopsis and visual acuity, with minimal or no compensatory head position or downshoot in adduction.


CONCLUSIONS
Patients in this case series show minimal, if any, long-term visual impairment.
Florida International University Herbert Wertheim College of Medicine, Miami, FL. Electronic address: Dsorr001@fiu.edu.
Dante
D
Sorrentino
Bascom Palmer Eye Institute, Pediatric Ophthalmology Consultants, Miami, FL.
Roberto
R
Warman
D002648:Child; D002675:Child, Preschool; D003867:Depth Perception / Q000502:physiology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015835:Ocular Motility Disorders / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D012189:Retrospective Studies; D014786:Vision Disorders / Q000503:physiopathology*; D014792:Visual Acuity / Q000502:physiology