Abstract

Surgical correction for congenital Brown syndrome is preferred in symptomatic patients. Among surgical procedures to weaken the superior oblique muscle, superior oblique tendon suture spacer also referred as Chicken suture lengthening is an effective method, although not commonly used.A 12 year old girl diagnosed with congenital Brown syndrome, using prism for past 2 years for double vision, presented to us for surgical correction of strabismus.On evaluation her BCVA was 6/6 BE with normal binocular single vision and abnormal head posture.In RE there is elevation restriction in adduction with hypotropia of 20 PD.FDT shows tight RE superior oblique muscle.RE superior oblique muscle lengthening done,placing Ethibond sutures 8 mm apart and tendon was cut.Post operatively patient was not having abnormal head posture and became orthophoric with minimal hypotropia.Superior oblique tendon suture spacer is very effective, intraoperatively adjustable and technically easier to perform.