Prepared by:

Angeline Julia C. Bangot

12- STEM C
Diagnosis:
A 10-year-old boy presented with a history of diminution of vision left face
turn, nystagmus and photophobia of both eyes for the last 7 years.
There were no similar complaints in the family members and no history of any
trauma or any systemic disease.
He had a visual acuity of 20/100 in right eye (RE) and 20/80 in left eye (LE)
(Snellen visual acuity chart) and was not improving with correction.
His near vision was N6 in both eyes (Times new roman chart). Cycloplegic
refraction showed a refractive error of + 1.0 Dioptre Sphere (DS) −1.5 Dioptre
cylinder (DC) at 180° in the RE and + 0.5 DS − 1.0 DC at 160° in the LE.
Cover test for distance and near, showing a left hypertropia in the forced
primary position
A Prism Bar Cover test showed 20 prism diopters (PD) of left hypertropia for
distance and 15 PD of left hypertropia for near
He was orthophoric in the preferred head posture
Indirect ophthalmoscopic examination showed an albinotic fundus with foveal
hypoplasia
A horizontal jerk nystagmus with null point in the right gaze was seen
Brown's syndrome
associated with
ocular albinism
Brown’s Syndrome
Brown Syndrome is a rare eye disorder
characterized by defects in eye movements. This
disorder may be present at birth (congenital) or
may occur as the result of another underlying
disorder (acquired). Muscles control the
movements of the eyes. Some of these muscles
turn the eyeball up and down, move the eyeball
from side to side, or enable the eyeball to rotate
slightly in its socket. The superior oblique
tendon sheath of the superior oblique muscle
surrounds the eyeball. The symptoms of Brown
Syndrome are caused by abnormalities of this
tendon sheath including shortening, thickening,
or inflammation. This results in the inability to
move the affected eye upward.
Signs & Symptoms
limited eye movement in the affected eye
The ability to move the eyeball toward the center (adduction),
or outward from the center (abduction), may be restricted or
absent
One eye may appear to be out of alignment with the
unaffected eye, especially when looking upward
droopy eyelid (ptosis)
widening of the eye (palpebral fissure) when looking upward
crossing of the eyes (strabismus)
hypotropia

ptosis
Ocular albinism
Ocular albinism (OA) is a genetic condition
that affects the pigment in the eyes. It
causes poor eyesight. OA does not affect
the pigment in the skin or the hair.
Albinism affects the retina and the optic
nerves. The retina is the inside lining of
the eye. It acts like a screen onto which
pictures are projected. In eyes affected
by albinism, the retina cannot produce a
sharp image and the nerves do not
transmit a clear image to the brain.
Signs & Symptoms

Eye colour
Iris transillumination
Nystagmus
Chiasmal misrouting
Light sensitivity
Treatment
Individuals diagnosed with ocular
albinism should be evaluated by an
ophthalmologist at the time of diagnosis
to determine the extent of the disease
and have ongoing ophthalmologic
examinations annually. Glasses or
contact lenses can greatly improve
vision. Dark glasses or a hat with a brim
can help to reduce sun sensitivity
(photophobia).