A 25-year-old male was referred to our ophthalmology service after accidentally shooting himself in the right periocular area with a BB pellet gun. According to the patient, the gun had fired a single spherical, red plastic BB pellet approximately 5 mm in diameter. He experienced immediate decreased vision and floaters and was initially seen in a peripheral emergency department. He did not recover the BB. A computed tomography (CT) scan of the orbits performed at the peripheral hospital was reported as negative for a foreign body.
Brown’s syndrome is an uncommon strabismus characterized by restriction of elevation in adduction and can be congenital or acquired.1–3 Clinical features include mild impaired elevation on upgaze, minimal/no elevation deficit on abduction, and minimal/no superior oblique overaction.1–3