In Brown syndrome (superior oblique tendon sheath syndrome), the characteristic finding on forced duction test is:

• A Restriction of forced elevation in adduction ✓
• B Resistance to forced depression in abduction
• C Free passive movement in all directions
• D Restriction of elevation in abduction only

Explanation

Brown syndrome is characterized by restricted passive elevation of the eye in adduction due to a tight superior oblique tendon/sheath preventing the superior oblique tendon from moving through the trochlea on attempted elevation in adduction. Forced duction test (pulling the eye toward elevation in adduction with forceps) demonstrates mechanical restriction. The extraocular muscles themselves are normal — the restriction is entirely tendon/sheath related. This distinguishes it from an inferior oblique palsy where there is no mechanical restriction.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.