Question
I’m in my 40s and have been diagnosed with Brown’s Syndrome. I’ve been told to visit a rheumatologist, as this syndrome may be associated with rheumatoid arthritis. Can you comment?
Answer
Brown’s syndrome is a form of strabismus or squint. It is manifest by a failure of the eyeball to elevate during adduction, which is the technical term for turning the eyeball inwards. Eye movement is controlled by a series of slender muscles inside the orbit that are attached to the external surface of the eyeball. The particular muscle that is implicated in Brown’s syndrome is the superior oblique muscle. Most cases of Brown’s syndrome are congenital and are usually left alone unless the strabismus is problematic. However, it can occur as a consequence of inflammatory conditions such as rheumatoid arthritis. It is postulated that the tendon of the superior oblique muscle becomes inflamed as a consequence of the diffuse inflammation that is a feature of rheumatoid arthritis. In that condition the inflammation can involve tendons and various tissues other than the joint surfaces. I would assume that you have been advised to attend a rheumatologist in order to verify if you have rheumatoid arthritis and also to receive specialist advice on further management of your condition.