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Surgery may not be advisable for patients with Brown's syndrome
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 Roberto Warman |
MIAMI — Long-term follow-up of patients with Brown's syndrome suggested a conservative, nonsurgical approach, according to a presenter here.
At the Bascom Palmer Eye Institute 50th Anniversary Scientific Meeting, Roberto Warman, MD, presented data on the largest reported series of patients with bilateral Brown's syndrome. The retrospective review included data on five girls and four boys with a diagnosis age ranging from 3 years to 6 years. Patients were seen at Miami Children's Hospital between 1987 and 2011, and follow-up averaged 7.5 years.
"Most patients with bilateral Brown's syndrome are idiopathic, start early in childhood and remain very stable. There can be sequential presentation and spontaneous resolution, as has been described in unilateral cases," Dr. Warman said.
Notably, most patients developed good stereopsis with minimal, if any, compensatory head positioning, and mild amblyopia developed only in those with horizontal strabismus and no stereopsis.
"Whenever possible, avoid surgery in unilateral cases until after amblyopic age, not only to avoid amblyopia postop but to see if [the patient] develop a sequential one in the other eye," Dr. Warman said.
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