Before undertaking surgery for Brown syndrome, the surgeon must first confirm the diagnosis by demonstrating restricted forced ductions at elevation in adduction then:

1. Make sure there is a good reason for undertaking surgery, such as diplopia, hypertropia, or a bothersome head posture

2. Prepare the patient to have lowered expectations

3. Be ready for a possible second surgery, including treatment for iatrogenic superior oblique palsy, especially if a superior oblique tenectomy is done.

4. Do not weaken the inferior oblique at the first procedure.

5. Remember that the little people grow up, meaning that restricted upgaze could become less of a factor.

. The Key of Success in any surgery adopted for Brown Syndrome is : Free forced ductions at the conclusion of surgery.