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Correction of Abnormal Head Position in Pediatric Nystagmus Using Yoked Low-Value Prism Glasses: A Retrospective

Ghaliah Nsour1,2, Mariana A M Misawa1,2, Jessica Adamuccio3

  • 1Toronto Western Hospital, Toronto, Ontario, Canada.

Investigative Ophthalmology & Visual Science
|February 2, 2026
PubMed

Insights

Low-value yoked prisms significantly reduced abnormal head posture (AHP) in children with nystagmus. This non-surgical approach offers a new therapeutic option to improve visual function and reduce associated difficulties.

Area of Science:

  • Ophthalmology
  • Pediatric Neurology
  • Vision Science

Background:

  • Nystagmus often presents with abnormal head positions (AHPs) to optimize visual acuity.
  • Surgical interventions are common, but yoked prisms are an underutilized therapeutic option.
  • AHPs can cause significant physical and social challenges for affected children.

Purpose of the Study:

  • To evaluate the efficacy of low-value yoked prisms in mitigating abnormal head posture (AHP) in pediatric nystagmus patients.
  • To assess the impact of prisms on binocular best-corrected visual acuity (BBCVA) and AHP reduction.

Main Methods:

  • Thirty-one pediatric patients with nystagmus were treated with yoked prisms tailored to their head turn direction.
  • Outcomes measured included binocular best-corrected visual acuity (BBCVA) and abnormal head posture (AHP) angles.
  • Pre- and post-prism measurements were compared to assess treatment effectiveness.

Main Results:

  • A statistically significant improvement in BBCVA was observed (P = 0.001).
  • Abnormal head posture (AHP) significantly reduced from 16.9° to 4.6° for distance vision (P < 0.0001).
  • AHP also significantly reduced for near vision, from 12.7° to 3.8° (P < 0.0001).

Conclusions:

  • Low-value yoked prisms are effective in reducing AHP in children with nystagmus.
  • Prism therapy offers a viable, non-surgical option to improve head posture and visual function.
  • This study quantifies minimal prism values, supporting prisms as an adjunctive treatment for nystagmus-related AHP.
Abstract

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