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Abnormal head posture associated with high hyperopia.

S A Havertape1, O A Cruz

  • 1Department of Ophthalmology, St. Louis University School of Medicine, Missouri, USA.

Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
|October 26, 1999
PubMed
Summary
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Children with high hyperopia may adopt a chin-down head posture to improve vision and maintain binocularity. This abnormal head posture resolves with corrective lenses, indicating its link to refractive error.

Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology
  • Optometry

Background:

  • Abnormal head posture can stem from ocular or non-ocular causes.
  • Common ocular reasons include maintaining binocularity and optimizing visual acuity.
  • Undercorrected or overcorrected refractive errors are linked to compensatory head postures.

Observation:

  • Five pediatric patients with symmetric high hyperopia (≥ +5.00 D) and abnormal head posture were studied.
  • A consistent chin-down head posture was observed when patients were not wearing corrective lenses.
  • This posture improved with eye occlusion and spectacle wear, with no significant strabismus noted.

Findings:

  • High hyperopia in children, even with minimal strabismus, can manifest as an abnormal head posture.

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  • The chin-down posture appears to be a compensatory mechanism for achieving better visual acuity.
  • The posture's resolution with corrective lenses and monocular testing supports its role in visual function.

    • Implications:

    • A chin-down head posture in children warrants investigation for high hyperopia.
    • Cycloplegic refraction is crucial for accurate diagnosis and management of high hyperopia.
    • Understanding this posture aids in early detection and intervention for visual impairments in children.