Brown synrome is an eye disorder, wherein movement of the superior oblique tendon is restricted, resulting in mechanical limitation of ocular elevation. Fibrous adhesions may affect the superior oblique tendon and trochlea in the upper medial quadrant of the orbit. Limitation of elevation is most marked in the adducted position, and elevation improvement occurs gradually as the eye is abducted. Clinically, Brown syndrome resembles isolated paresis of the inferior oblique muscle (a much rarer condition). Forced duction testing is diagnostic (using the so-called "Guyton maneuver" or exaggerated traction test), with palpable resistance to elevation in adduction when Brown syndrome is present. The condition is usually unilateral and idiopathic, though rarely it may be due to trauma or inflammation. Brown syndrome may be congenital or acquired.