Article

Head tilt-dependent esotropia associated with trisomy 21.

Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis Children's Hospital, One Children's Place, St. Louis, MO 63110, USA.
Ophthalmology (impact factor: 5.45). 04/2004; 111(3):596-9. DOI:10.1016/j.ophtha.2003.07.007 pp.596-9
Source: PubMed

ABSTRACT To describe a series of patients who used a head tilt to control esotropia.
Retrospective noncomparative case series.
Seven children with esotropia that decreased with their compensatory abnormal head tilt. Six of the patients had trisomy 21. The patients had no other identifiable etiology for their head tilt, including no oblique muscle dysfunction, nystagmus that changed with head tilt, or uncorrected refractive error.
Six patients underwent horizontal extraocular muscle surgery. Preoperative evaluation in 4 patients included assessment of the change in head position with either monocular occlusion or prisms.
Ocular alignment in primary position and improvement in abnormal head tilt after surgery.
In the 4 patients who underwent preoperative testing, the abnormal head tilt resolved with either monocular occlusion or prisms. The head tilt and esotropia were eliminated or improved in all patients who underwent strabismus surgery.
Abnormal head tilt may be used as a compensatory maneuver to improve purely horizontal strabismus. This finding appears to be associated with trisomy 21. Horizontal extraocular muscle surgery may improve the head tilt in such patients.

0 0
 · 
0 Bookmarks
 · 
40 Views
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

4 patients
 
abnormal head tilt
 
children
 
compensatory abnormal head tilt
 
compensatory maneuver
 
head position
 
head tilt
 
horizontal extraocular muscle surgery
 
horizontal strabismus
 
identifiable etiology
 
monocular occlusion
 
oblique muscle dysfunction
 
Ocular alignment
 
patients
 
Preoperative evaluation
 
preoperative testing
 
Retrospective noncomparative case series
 
strabismus surgery
 
trisomy 21
 
uncorrected refractive error
 

Gregg T Lueder