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Related Experiment Videos

Dissociated vertical deviation and head tilts.

A P Santiago1, A L Rosenbaum

  • 1Department of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles 90095, USA.

Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
|October 26, 1999
PubMed
Summary

Anomalous head posture is often linked to dissociated vertical deviation (DVD). Head tilts can improve motor control of DVD, and strabismus surgery can correct both conditions.

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Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology
  • Neuro-ophthalmology

Background:

  • The association between anomalous head posture (AHP) and dissociated vertical deviation (DVD) is underrecognized, with limited existing literature.
  • This study investigates the relationship and clinical implications of AHP in patients with DVD.

Purpose of the Study:

  • To explore the association between anomalous head posture and dissociated vertical deviation.
  • To determine the effect of head posture on the control of dissociated vertical deviation.
  • To assess the impact of strabismus surgery on both conditions.

Main Methods:

  • A retrospective case series of 14 patients with AHP and DVD.
  • Analysis of head tilt patterns and their effect on DVD magnitude and motor control.

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  • Evaluation of sensory testing (stereopsis, Worth 4 dot) and outcomes after strabismus surgery.

    • Main Results:

    • Most patients (12/14) exhibited head tilts contralateral to the larger or affected eye.
    • Forced contralateral head tilting worsened DVD control, while opposite tilting improved it.
    • Strabismus surgery improved or resolved AHP in four patients and enhanced stereopsis in two.

    Conclusions:

    • Dissociated vertical deviation should be considered in the differential diagnosis of ocular causes of head tilts.
    • Head tilt testing can aid in diagnosing DVD as the cause of AHP.
    • Surgical management of DVD can lead to improvements in anomalous head posture.