Scoliosis and vertical ocular muscle paresis

Patients with a head tilt from a vertical ocular muscle paresis can often be shown to have an accompanying scoliosis. The scoliosis is usually mild and is postural or compensatory. Although this association is quite common, it is very rarely commented upon, because the relationship between the spinal and the ocular problem is little known. It is important because if such a patient presents with a scoliosis, the patient can be spared extensive investigations if the ocular muscle paresis is of long standing and the Orthopaedic surgeon will know he is, most likely, dealing with a mild scoliosis, and one that has a cause. If the ocular muscle paresis is operated upon early enough it may be possible to remove the head tilt and have a good influence upon the scoliosis. Six patients illustrating these points are discussed.