Head Posturing in Horizontal Strabismus

Abstract

Head turning to the right or left may enable a patient to avoid diplopia, gain single binocular vision, or avoid a restricted gaze position. Head turns for these reasons may be seen with horizontal muscle palsies, Duane's Syndrome, or incomitant deviations after muscle surgery. Head turning may also provide better visual acuity by decreasing nystagmus, or by producing a pinhole effect by partial occlusion of the pupil. In cases of ocular motor apraxia, a rapid head turn or thrust helps the patient move his eyes into a desired field of gaze.

The purpose of this paper is to review the possible etiologies for head posturing in the presence of a horizontal strabismus.

• head posturing
• oculomotor muscle paresis
• innervational anomalies
• mechanical anomalies