Approach to the Patient with an Abnormal Head Posture
Jill T. Clark, C.O.
In the initial approach to the patient with an abnormal head posture, the examiner must first consider that the position may arise from either an ocular or a non-ocular condition. There are primarily two ocular reasons for an abnormal head posture: (1) The patient is either attempting to improve vision, or (2) The patient is attempting to maintain binocularity and fusion, Patients who have an uncorrected refractive error, nystagmus, a visual field defect, or bilateral ptosis, may assume an abnormal head posture in an attempt to improve vision. Unilateral ptosis and incomitant strabismus are the two primary causes of an abnormal head posture in patients who are making an effort to maintain binocularity and fusion. Non-ocular causes of torticollis are primarily the result of a muscular or skeletal abnormality. This article presents a general overview with a systematic approach to the evaluation of the patient with an abnormal head posture.
© 1996 The Board of Regents of the University of Wisconsin System