Ocular Abnormal Head Posture

Khorrami-Nejad, Masoud; Akbari, MohamadReza; Kangari, Haleh; Baghban, Alireza Akbarzadeh; Pazouki, Mehdi Ranjbar

doi:10.4103/joco.joco_114_20

Cited by 11 publications

(7 citation statements)

References 78 publications

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“…Strabismus is the leading cause of OT (80%) in the general population, with incomitant strabismus as the most frequent form (80%) [ 39 , 40 , 41 , 42 ]. Nystagmus is found as the second leading cause [ 18 , 39 , 40 , 41 , 42 , 43 ] followed by infantile esotropia [ 39 , 41 ].…”

Section: Discussionmentioning

confidence: 99%

Torticollis in Non-Syndromic Unicoronal Craniosynostosis Is Predominantly Ocular Related

Tan,

Rostamzad,

Esser

et al. 2023

JCM

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(1) Background: Patients with unicoronal craniosynostosis (UCS) often show torticollis which can result from either an ocular cause or contraction of the sternocleidomastoid muscle. For clinicians, it is crucial to know the prevalence of ocular torticollis (OT) to ensure appropriate referral for treatment. Furthermore, associated ophthalmic features with OT in these patients are scarcely described. The aim of this study was to determine the prevalence of OT in non-syndromic UCS patients and investigate its associated ophthalmic features. (2) Methods: In this descriptive cross-sectional study medical records of non-syndromic UCS patients treated between 1994–2022 in one tertiary care hospital in The Netherlands were retrospectively reviewed. Collected data included: diagnosis and type of torticollis, binocular single vision (BSV), strabismus, ocular motility, alphabetical patterns, refractive error, and amblyopia. Patients were classified as OT, based on their ophthalmic and/or orthoptic diagnosis. Prevalence was determined with the 95% CI using the Clopper–Pearson exact test. Associations between OT and the ophthalmic features were determined using Chi-square or Fishers’ exact test and its effect size was calculated using Cramer’s V. (3) Results: In total, 146 patients were included, of whom 57 had torticollis. An ocular cause for the torticollis was found in 54 patients. The prevalence of OT was 37% (n = 146; 95% CI [0.292–0.454]). Significant associations were found between OT and strabismus (p < 0.001), ocular motility abnormalities (p < 0.001), alphabetical patterns (p < 0.001), and amblyopia (p = 0.002). BSV (p = 0.277) and refractive error (p = 1.0) were not significantly associated with OT. However, in OT the BSV was relatively poor (42.1%) and more frequently absent (26.3%) compared to the non-torticollis group (7% poor and 16.3% absent). In both groups, excyclotorsion was predominantly present (62.3%). (4) Conclusions: In 95% of cases, torticollis in UCS patients is ocular-related. Overall, one in three patients with UCS have OT. This study emphasizes the importance of a timely referral of all patients with UCS with torticollis to an orthoptist and/or ophthalmologist, specialized in diagnosing and treatment of OT, before considering physiotherapy.

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Section: Discussionmentioning

confidence: 99%

Torticollis in Non-Syndromic Unicoronal Craniosynostosis Is Predominantly Ocular Related

Tan,

Rostamzad,

Esser

et al. 2023

JCM

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“…An ocular defect, either congenital or acquired, can result in a compensatory head rotation or chin-up/chin-down motion to improve binocular vision [20]. The term abnormal head posture (AHP) is used in the ophthalmology and visual science literature, in addition to ocular torticollis, to describe any deviation of the head from its normal angle and direct position [21 ▪▪ ]. A misalignment in the visual axes (strabismus) may result in compensatory head positioning [20].…”

Section: Ocular Torticollis/abnormal Head Posturementioning

confidence: 99%

“…A misalignment in the visual axes (strabismus) may result in compensatory head positioning [20]. AHP may occur at any age and be congenital or acquired [21 ▪▪ ]. The examiner must consider all causes throughout the evaluation.…”

Section: Ocular Torticollis/abnormal Head Posturementioning

confidence: 99%

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The tilts, twists, and turns of torticollis

Gross

Chipman²,

Doyle³

2022

Current Opinion in Pediatrics

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Purpose of reviewThe purpose of this review is to outline the most recent understanding of torticollis in the pediatric population.Recent findingsIt is important to diagnose the underlying condition of torticollis early in childhood, as some conditions that cause torticollis may result in major developmental delays in early motor milestones. Recent studies have highlighted that many of the rarer causes of torticollis are often misdiagnosed as congenital muscular torticollis, suggesting that physicians should pay close attention to the results of clinical and radiographic examinations when patients present with torticollis.SummaryCongenital muscular torticollis is the most common cause of torticollis. Other, less common causes of torticollis include vertebral abnormalities, ocular torticollis, gastrointestinal disorders, soft tissue infections of the neck, posterior fossa tumors, and benign paroxysmal torticollis. Although rare, these differential diagnoses should be considered during a clinical work-up for a patient who presents with torticollis.

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“…The vicious head position is a compensatory position which aims to provide better visual efficiency and a binocular vision to the patient, insinuating that the problem isn´t (primarily) on the neck, but it's in the head (seeing, listening), which position is vicious (defective) and not casual [27]. It compromises the aesthetic long term and can cause orthopedic disorders and facial asymmetry [28].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of cervical postural alterations in oculomotor disturbances: a Brazilian cohort study

Dos Santos,

De Albuquerque-Filho,

Campos

et al. 2023

BJCR

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The literature suggests that maintaining correct posture depends on a balance between orientation and balance, which is linked to the reflex relationship between the oculomotor system and the superior cervical spine. Any disruption to this relationship can cause postural deviation, as the posture is dependent on head balance and eye horizontality. This study aimed to investigate the prevalence of cervical posture alterations, such as head tilt, rotation, and protrusion, scapular waist changes, scoliosis, kyphosis, and lumbar hyperlordosis, in patients with oculomotor disturbances, including convergent, divergent, and vertical squint, and convergence insufficiency. The study evaluated 24 patients aged between 4 and 39 years old, both male and female, through ocular motility and postural examination. The results showed that all patients with oculomotor disturbances also had postural imbalances, and the percentage of alterations in the posture segments was high. Therefore, oculomotor disturbances can cause postural imbalance, leading to orthopedic and facial asymmetry. The study concluded that patients with oculomotor disturbances should be evaluated to determine the compensatory positions they adopt and set a better visual performance that does not alter their appearance in the long term.

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Ocular Abnormal Head Posture

Cited by 11 publications

References 78 publications

Torticollis in Non-Syndromic Unicoronal Craniosynostosis Is Predominantly Ocular Related

Torticollis in Non-Syndromic Unicoronal Craniosynostosis Is Predominantly Ocular Related

The tilts, twists, and turns of torticollis

Prevalence of cervical postural alterations in oculomotor disturbances: a Brazilian cohort study

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