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An abnormal or compensatory head posture (AHP) occurs when the head is deviated out of its primary and normal straight position. The medical term for an AHP is \u201ctorticollis\u201d, deriving from the Latin words \u201ctortus\u201d (twisted) and \u201ccollum\u201d (neck). In turn, a torticollis whose cause relates to an eye disease is called \u201cocular torticollis\u201d.<\/p>\n
Usually, evaluating torticollis in children requires a multidisciplinary engagement, involving paediatrics, orthopaedists, neurologists, physiatrists and physiotherapists. Consulting an ophthalmologist is additionally common and normal in order to discard ocular causes for the torticollis. On the other hand, a non-treated ocular torticollis lasting for years may lead to contractures and permanent musculoskeletal abnormalities, eventually resulting in chronic neck ache or headache.<\/p>\n
Torticollis may involve head rotation around any of the three main axes:<\/p>\n
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Congenital torticollis, meaning torticollis from birth, is more frequently due to muscular or skeletal abnormalities. In exchange, ocular torticollis rarely occurs in the first weeks of life. Trauma must always be discarded as a possible cause for any acquired abnormal head posture.<\/p>\n
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Congenital muscular torticollis is the most common torticollis type at birth. It is caused by discrete and painless muscular \u201cfibroma\u201d in one of the neck sides, being especially related to the sternocleidomastoid muscle. Acquired disorders include traumatic and non-traumatic causes (mainly neurological ones).<\/p>\n
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The purpose of the ophthalmologist is to determine whether there is an eye cause for the compensatory posture. In this case, the treatment can be planned to eliminate or smooth out the problem and restore a normal head posture.<\/p>\n
Ocular torticollis arises from disorders in the afferent visual pathway, motor ocular nerves or in the vestibular apparatus, leading to changes in the normal neurological balance for the neck muscles. AHP may arise as one of several goals:<\/p>\n
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The child usually needs to be observed by a doctor for a considerable period of time to determine whether the torticollis is constant in its orientation or whether it changes, and whether it is fixed or intermittently dependent on visual tasks. Abnormal physical characteristics such as dysmorphism or nystagmus<\/a>\u00a0can provide clues about the aetiology. Photographic or video records from the first years of life may also help in the diagnosis.<\/p>\n So\u2026 what are some of the ocular pathologies causing torticollis?<\/p>\n <\/p>\n <\/p>\n Thus, we realize that most children adopt a head posture to improve their vision. Therefore, in general, it is important not to discourage abnormal posture in these children until the underlying problem can be corrected.<\/p>\n <\/p>\n Yes, there is<\/strong>. Ocular torticollis can be improved by treating the causal factor. Treatment may include surgery in the case of AHP related to strabismus, nystagmus and ptosis; or the use of eyeglasses for refractive errors or inter-ocular asymmetries of visual ability.<\/p>\n On December 20th 2021, Doctor Paulo Freitas da Costa was the guest at Porto Canal\u2019s TV show program<\/a> \u201cConsult\u00f3rio\u201d, where he had the chance to clarify some doubts regarding this topic! See the video in\u00a0Youtube<\/a><\/p>\n <\/p>\n <\/p>\n Sources:\n
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Is there any treatment?<\/h4>\n
\n<\/em>academia americana de oftalmologia<\/a>; associa\u00e7\u00e3o americana de oftalmologia pedi\u00e1trica e estrabismo<\/a>[\/vc_column_text][vc_empty_space height=”50px”][vc_video link=”https:\/\/www.youtube.com\/watch?v=VgSBYFt6ljM”][vc_empty_space height=”50px”]