Traumatic simulated Brown's syndrome: a case report.

A case report of a simulated Brown's tendon sheath syndrome is presented which masks as an orbital floor fracture with entrapment. Despite a positive forced traction test, additional diagnostic information such as a normal tomographic exam of the orbital floor, vertical saccadic up gaze velocity measurements consistent with edema and hemorrhage, greater limitation to elevation in adduction than abduction, and tenderness and soft tissue injury in the region of the trochlea, persuaded us to conservatively manage this case. It behooves the ophthalmologist to consider a temporary superior restrictive phenomenon produced by edema prior to any surgical approach to improve elevation of the globe.