Abnormal Head Posture in Restrictive Strabismus
Joseph L. Demer, M.D., Ph.D.
Ocular torticollis, a spontaneous anomalous head posture, may be a presenting clinical sign of restrictive strabismus, For proper management, restrictive strabismus must be distinguished from paralytic strabismus using a variety of means, including: tests of versions, presence of incomitance and secondary deviation, saccadic velocity, forced duction, and force generation.
Causes of restrictive strabismus include congenital fibrosis, Brown syndrome, orbital anomalies, globe anomalies, myopathies, traumatic muscle and connective tissue entrapment, endogenous orbital mass, implanted orbital hardware, and muscle shortening. The cornerstone of management of ocular torticollis due to restrictive strabismus is release of the restriction to ocular rotation, usually by strabismus surgery.
© 1996 The Board of Regents of the University of Wisconsin System