1. Congenital onset

 A. Congenital Brown syndrome
 B. Inelastic muscle-tendon complex

2. Anomalies of Superior Oblique Tendon fibers
3. Congenital pseudo-Brown Syndrome-anomalous inferior orbital adhesions
4. Posterior orbital bonds
5. Acquired onset

 A. Acquired Brown syndrome
 B. Peritrochlear scarring and adhesions
 C. Chronic sinusitis

6. Trauma-superior temporal orbit
7. Blepharoplasty and fat removal
8. Lichen sclerosis at astrophicus and morpheae
9. Tendon-trochlear inflammation and edema
10. Idiopathic inflammatory (pain and click)
11. Trochlearitis with superior oblique myositis
12. Acute sinusitis
13. Adult rheumatoid arthritis
14. Juvenile rheumatoid arthritis
15. Systemic lupus erythematosus
16. Possibly distant trauma (CPR [cardiopulmonary resusitation] and long-bone fractures)
17. Possibly postpartum hormonal change
18. Superior nasal orbital mass
19. Glaucoma implant
20. Neoplasm
21. Tight or inelastic superior oblique muscles
22. Thyroid disease (inelastic muscles)
23. Peribulbar anesthesia (inelastic tendon)
24. Hurler Scheie syndrome (inelastic tendon)
25. Superior oblique tuck (short tendon)
26. Idiopathic
27. Acquired pseudo-Brown syndrome
28. Orbital fracture
29. Retinal band around inferior oblique muscle
30. Inferior temporal adhesion
31. Following double plate Molteno implantation

Dobler-Dixon AA, et al. Prospective evaluation of extraocular motility following double-plate molteno implantation. Arch Ophthalmol 1999; 117: 1155-1160.

Kaban JT, et al. Natural history of presumed congenital Brown's syndrome. Arch Ophthalmol 1993; 111:102.

Wang FM, et al. Brown's syndrome in children with juvenile rheumatoid arthritis. Ophthalmology 1984; 91:23-26.

Wilson ME, et al. Brown's syndrome. Surv Ophthal 1989; 34:153.