Brown described a ocular motility disorder referred to as the superior oblique tendon sheath syndrome.
Consistent features include:
(1) There is limited eye elevation in adduction (looking towards the nose).
(2) There is normal or near normal elevation in abduction (looking lateral).
(3) There is a mild elevation deficit in primary position.
(4) There are positive forced ductions up and in.
(5) There is no or minimal superior oblique overaction.
Features that may be variable:
(6) There may be down shoot in adduction.
(7) There is usually divergence in straight-up gaze (V-pattern).
(8) There is usually widening of the palpebral fissure on adduction.
(9) There is often a backwards tilting of the head (compensatory chin elevation for binocular fusion).
(10) There is hypotropia in primary position.
