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A Girl with a Constant Head Tilt

A seven year old girl, Asha (name changed to protect privacy) came to the Pediatric Ophthalmology Department at Advanced Eye Hospital with an abnormal head posture since 1-2 years of age. She had nystagmus (wobbly eyes, involuntary to and fro eye movements) since birth. Asha was the first born child of a non consanguinous marriage. The period before and around her birth was uneventful. All her milestones had been normal. There was no family history of nystagmus or any other ocular or ear problem. She had no history of day or night blindness.

 Dr Prachi Agashe, Pediatric Ophthalmolgist at AEHI, Vashi, examined Asha to find out why she was maintaining this peculiar head posture. It was found that her visual acuity with the head posture with both eyes open was 6/9 (which means that Asha can see at 6 metres what a person with normal vision can see at 9 metres). Dr Agashe found that she had a left beating horizontal jerk nystagmus with null zone (area in which nystagmus is the least) in the right gaze. Hence she maintained a  left-face-turn for the majority of the day to attain good vision.

She underwent nystagmus surgery in both her eyes with the purpose of correcting her head posture and also reducing the severity of her nystagmus. After the surgery, Asha’s face turn was totally corrected and she achieved good binocular vision with a normal head posture.


Take Home Message

Child with an abnormal head posture needs an ophthalmologist reference to rule out ocular causes of an abnormal head posture.

The common ocular causes of an abnormal head posture include uncorrected refractive error (mainly astigmatism), squint, ptosis and nystagmus.

About Advanced Eye Hospital and Institute:

Advanced Eye Hospital and Institute (AEHI) in Sanpada, is a friendly eye clinic for children in Navi Mumbai where pediatric ophthalmologist treat children with for all the eye diseases. AEHI is the one of the best eye clinics that examines children regularly for Nystagmus i.e. involuntary eye movement and provide them with customized care. Treatment for Nystagmus with abnormal head posture needs intervention of an eye specialist. At AEHI, every child goes through detailed eye check-up with utmost care.