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Acquired Brown superior oblique tendon sheath syndrome. A 52-year-old man had extensive nasal sinus and skull base surgery followed by radiation, for an invasive carcinoma. This photograph of the patient's ocular motility shows Brown tendon sheath syndrome of the left eye. As the left eye is adducted, the tethered superior oblique tendon gives no slack, forcing the eye to rotate down. This is most evident when the eye is adducted in elevation, with a downshoot as the eye is turned toward the nose (asterisk). This patient also has a right abduction deficit. Source: Ocular Motility Disorders: Extraocular Muscles and the Neuromuscular Junction, Practical Neuroophthalmology Citation: Martin TJ, Corbett JJ. Practical Neuroophthalmology; 2013 Available at: http://mhmedical.com/ Accessed: April 30, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved
