Novel association of ocular myasthenia gravis with Brown syndrome in an adult

Brown syndrome is an ocular misalignment disorder affecting the superior oblique tendon-trochlea complex. We report a case of a 45-year-old woman with protracted symptoms of presumed idiopathic Brown syndrome later diagnosed as ocular myasthenia gravis. Acquired Brown syndrome secondary to ocular myasthenia gravis has not previously been reported in the literature. Ocular myasthenia gravis should be considered a differential in any patient presenting with vertical strabismus presenting as Brown syndrome.