45 y/o male with sudden eye misalignment—anyone relate?

@s0. Welcome to Mayo Clinic Connect where we provide support to one another.

I was unfamiliar with Brown's syndrome so I looked it up from a valid and reliable source.

Cleveland Clinic: Brown syndrome:

-- https://my.clevelandclinic.org/health/diseases/24195-brown-syndrome

I can understand how distressing this is for you. While we wait for others in this Support Group to respond may I ask you a few questions?

What did your ophthalmologist tell you about Brown's syndrome? Did your doctor recommend any treatment that you are following?

I’m a 64 y.o. female. That happened to me when I was about 8 months pregnant with my second child at age 29. Thankfully, it only lasted about a month.

It started with double vision, like you said, then my right eye became misaligned. I couldn’t read or drive. I had to wear an eye patch because the double vision made it difficult to do anything.

It was very scary because neither my GP, OBGYN, or Ophthalmologist knew what was going on. But, like I said, it resolved itself within a month. My eye slowly went back to center.

Many years later, when I had to see a retina specialist about glaucoma, I described to him what had happened to me. He knew right away that my pregnancy had caused my oblique muscle to swell (as described in the link below), which restricted eye movement. That made sense, since I was visibly swollen because of pregnancy. It was a relief to have a diagnosis after all those years, even though it never happened again.
https://my.clevelandclinic.org/health/diseases/24195-brown-syndrome

Are you speaking of misalignment of the placement of your eye or misalignment in your vision...like seeing double images?

The Stanford physician thinks it might be Brown's syndrome, which affects the pulley system of the eye, causing misalignment of the eye itself. My eyes were normal in the spring, but now when I try to look in certain directions, my left eye points higher and my right eye moves toward my nose. This causes misalignment in both the placement of my eyes and my vision, which results in double vision.

I just looked up Brown Syndrome. Cleveland Clinic web page says is a form of Strabismus and usually temporary. However, it seems like your experience is not going away and pretty severe.

I was born with Strabismus - esotropia (eye turn in) and Amblyopia (lazy eye). Had successful surgery as a toddler in one eye only many decades ago.

During the recent Pandemic, I started experiencing the same as you and eventually had the eye turn in and severe double vision (side by side and up) in certain gazes. I had specialized testing and then was referred to a Pediatric Ophthalmologist even though I was 64! Only about a dozen Specialists in my entire State.

I was diagnosed with Hypertropia (eye movement upward) and Esotropia (eye turn in). The diopter measurements were too severe for prisms to correct. Beginning of this year, I had surgery on both eyes.

Surgery took about 2 1/2 months later until I had a good result. No more double vision, eye turn, and only a tiny bit of distortion at far gazes. Since last April, I have been able to drive easily again.

I am reading that Brown Syndrome is normally treated more conservatively, but your double vision seems extreme. I went through AAPOS site to get to my testing center then was referred out for further evaluation. There is a find a doctor link on top left hand side:
https://aapos.org/glossary/brown-syndrome

i developed eye misalignment and double vision in my 60s. My neuro-ophthalmologist has helped me a lot. That rare speciality is found is find in top teaching hospitals