Treatment and Care of Brown Syndrome

Brown syndrome is a rare form of disease and the person who is affected faces problems in elevation of eye. This problem is caused due to defects in superior oblique tendon and people face problems particularly when their eye moves towards the nose. There are two types of care possible for this problem, they are as follows:

Medical Care

It is very difficult to get spontaneous resolution in cases of Brown syndrome. Only in some of the non-traumatic cases the fast resolution is possible. Since there is slow progress in the resolution process it is good to try out the conservative approach. Patients who suffer from acquired Brown syndrome can be evaluated for any coexisting disease. If there is some other systemic disease like sinusitis or rheumatoid then the disorder must be treated accordingly.

It is important to avoid all the systemic disease and then start the treatment of Brown syndrome. The main reason behind this is that the medicines used in treating this disease are anti-inflammatory. One of the best choices for this disease is Oral ibuprofen. Sometimes people use injections containing local steroids of trochlea. If the inflammatory process is controlled then the inflammatory Brown syndrome can show spontaneous resolution.

Brown Syndrome

Surgical Care

Surgery is done in severe cases like problems in chin elevation and limitation in elevation in the adduction. Surgery is mainly done in cases that last for too long and don’t show much improvement. The main process involved in the treatment of the superior Brown syndrome involves improvement in the length of tendon. One should release any kind of restriction and also try to avoid oblique palsy.

To go through the process properly the first thing that needs to be done is to identify the cause of the restriction. One of the most preferred methods is Wright silicone tendon expander. In this technique superior oblique tendon is elongated with the Tenotomy procedure. A segment of medical grade silicone is inserted that has 240 retinal bands and is kept between the ends of tendon. It is important to place silicone inside the tendon capsule without damaging the floor of tendon capsule. This has been the most effective technique but it is difficult to perform and requires precision.

There is another technique of superior oblique split tendon lengthening. In this technique the nasal side tendon that is present on the superior rectus muscle is split. Tendon halves are removed and their length is increased and the tendon is again joined.

In a technique known as Suture Bridge the doctors place a non-absorbable suture to connect the ends of superior oblique tendon. This is very effective in preventing oblique palsy and has proved to be good in correction of the Brown syndrome.

Proper Treatment of Amblyopia in Adults

This condition is commonly known as ‘lazy eye’ in which vision fails to develop properly in one eye. Treatment of Amblyopia in adults and also in kids should be done properly as the vision might be permanently affected if the condition is left untreated. Vision impairment is almost certain because as the brain of the child matures, it’ll ‘completely ignore’ the images coming from that affected eye. This condition is quite common, as surveys conducted states that 2-3 out of every 100 children suffer from this condition. The ideal and perfect time to correct amblyopia is early childhood or infancy.

There are numerous cases in which this condition gets fully ignored by parents, resulting in a great number of amblyopia-affected children all over and it’s still growing. Though the treatment is more result-oriented if treated at childhood, but there exists a good number of possibilities for treatment of amblyopia in adults.

treatment of amblyopia in adults

Eye-patch method

It is the most popular and common method among the treatment of Amblyopia in adults in which an eye-patch is used to cover up the good eye, so that the brain tries to utilize functioning of the ‘bad’ eye as much as possible. It’s quite an effective procedure and can be done at home. One needs to use the eye-patch for a minimum 2-3 hrs every day while doing some eye exercises on the lazy eye. It can be hard for some at first but not impossible, and results will start showing within first few weeks.

Focusing on small objects

This is a great method in which one should try to focus on small objects by wearing the patch. One could also play videogames especially the heavy duty action ones, read a book, or do some work that require one to focus the eyes.

Training of the vision naturally

Three methods are usually involved in this process. The first one is rolling the ‘lazy eye’ 20-30 times in clockwise and anti-clockwise motion, and repeating the process several times, but one should be extra careful not to exaggerate it so as to cause strain on the eyeball.

Next method is to focus on an object (which should be small) that is being placed at a distance so as to make the ‘lazy eye’ focus harder at it. After keeping it that way for some time, one should immediately try to adjust on something kept close by and then should re-focus on the far object once more. This process should be repeated several times too.

The last one is known as tracking in which an object such as a pen, pencil or a finger should be held in front of the nose and should be moved from left to right slowly, which needs to be tracked by the ‘lazy eye’.

Treatment of amblyopia in adults is also possible through surgery but it fails to cure the neural pathways between the brain and the eye, and can create a misalignment with the weak eye.

Eye Treatment through Laser Eye Surgery

People who suffer from problems of vision and look for an alternative to glasses and lenses go for laser eye surgery. The visual activity of the eye is improved by altering the shape of cornea. There are some side effects of this surgery like starbursts, keratoconus, halos, problems of night driving and eye dryness. All the problems like farsightedness, nearsightedness or astigmatism can be solved through laser surgery.

Advantages of laser eye surgery

It has a huge success rate of around 90% and it has shown proven results. Patients surely have corrected vision after this surgery and get desired results. There is negligible amount of pain and there is no requirement of any bandage or any stitch. People can get adjustments made after few years of surgery if they want. The dependence on contact lens or glasses is reduced.

Laser Eye Surgery

Disadvantages of laser eye surgery

Some of the disadvantages are the change of cornea can never be reversed. It is very complex and if by mistake the doctor cuts the flap then the vision will go permanently.

Getting prepared for the surgery

It is important to meet a good coordinator so that one gets to know what he needs to do after and before this eye surgery. The medical history of the person will be properly evaluated before the examination is conducted. The initial tests of this surgery include corneal mapping, measuring the thickness of cornea, refraction, pupil dilation and air pressure. Once all the tests are done the person can meet the surgeon and ask any question that he has.

Once should stop wearing the contact lens three weeks before the evaluation starts and should also make sure he brings his glasses to the surgeon. The day when the laser eye surgery is going to happen the person must have light meal and avoid any type of makeup.

The procedure

During the surgery an instrument known as microkeratome is used. This helps in cutting the flap of the cornea. Then the cornea is peeled back and the tissue lying under the cornea is reshaped. Once the cornea is properly reshaped the doctor tries to focus light on the retina. Finally the flap will be put back in its place and the surgery will be completed.

Precautions required after the surgery

After Laser eye surgery the eyes become dry and one should make sure that proper precaution is taken to keep it in good condition. One should continuously use the eye drops given by the doctor after the surgery. The eye should be kept moist and any type of inflammation should be prevented. The eye gets healed very rapidly after the surgery and people can get back to action quickly. On the first day after the surgery one might face blurred vision but the vision will be normal in few days.