The Influence of the Head Posture on the Motor Alignment and Sensory Status in the Patients with the Abnormal Head Posture

ABSTRACT

PURPOSE: To analyze clinical manifestations of the abnormal head posture of ocular origin and to evaluate the effect of the abnormal head posture on the improvement of binocularity. METHODS: In this prospective study 58 patients with abnormal head posture of ocular origin were enrolled. Best corrected visual acuity, Titmus stereotest, Worth four dot test at near and far and the deviations at far were recorded in the abnormal head posture and the forced primary position. Changes of the head postures and the stereoacuity were evaluated postoperatively in the operated cases. RESULTS: The most common cause of abnormal head posture was superior oblique palsy and the most common type of that was head tilt. The deviating angles were significantly decreased in 30 patients (80%) and not changed in 8 patients (20%) of 38 patients with strabismus in abnormal head posture compared to the forced primary position. However, the results of Titmus stereotest improved only in 28% of patients in abnormal head posture. Six among 7 patients with nystagmus showed the disappearance of nystagmus in the abnormal head posture. Twenty (90%) among 22 patients who had surgical procedures showed improvement in the head posture. CONCLUSIONS: The abnormal head posture improved the motor alignment in most of the strabismus patients. However, in many patients it failed to improve the sensory status or binocularity. Most patients who had surgical procedures showed the improvement of abnormal head posture.