Clinical Assessment of Anomalous Head Postures in Children

ABSTRACT

PURPOSE: The purpose of this study is to establish techniques in evaluating and planning therapy in children who presented anomalous head postures (AHP). METHODS: We studied the types of AHP, the different causes and their frequency, and therapeutic results in children who presented with a complaint of an AHP at the department of ophthalmology. RESULTS: Of 55 children, there was ocular AHP in 49, muscular AHP in 3, hearing loss in 1, and idiopathic AHP in 2 cases. Frequency of the ocular AHP was as follows: strabismus in 22, refractive error in 18, amblyopia in 6, and nystagmus in 3 cases. Superior oblique palsy and astigmatism were most common in each group. The main form of AHP was head tilt in the group of strabismus and face turn in the group of refractive error. Of 19 children with strabismus who underwent surgery, AHP was corrected completely in 12, partially in 6, and not corrected in 1 case. The age at surgery was younger in the group with completely corrected than in the group with partially corrected or failed (4.2: 6.1 years, p=0.04). CONCLUSIONS: The evaluation for strabismus and refractive error as the first step may help treat children with ocular AHP. In the case of AHP due to strabismus, it is important to operate as soon as possible for complete success.