“Can eye movement problems be related to torticollis?”

Ocular Torticollis

Torticollis can be caused by several things. Delays or problems in the integral development of muscle tone, the vestibular system and propreioception can all be causes.  Eye alignment, nystagmus and acuity problems can also affect head position.  When vision is the primary cause for torticollis, it is referred to as ocular torticollis.  One study found 20% of torticollis related to ocular problems. (1)

Eye alignment

Head tilts and head turns are common signs of eye alignment problems. Deviations between eyes in the horizontal plane (hyper- or hypo- tropia) can cause head tilts in the brains attempt to see a single, fused image. Head turns (rotation) to right or left can be caused by strabismus (eso- or exo- tropia). Again, the brain turns the head in attempt to not see double. Other more complex movement patterns can also cause head position and posture problems.

Nystagmus

Nystagmus is an involuntary movement of the eyes. This is generally associated with a neurological problem. They can be congenital or acquired. Many times, patients with a nystagmus will turn their head to find the point at which the nystagmus stops. This point, called the “null point” allows for improved vision for the patient.

Acuity problems

Astigmatism, a condition in which the eyeball is not perfecting round but more football shaped, can also cause visual acuity problems that might facilitate a head tilt in order to improve vision.

Eye Exam

Every child should have their first eye exam at 6 months (per AOA recommendations). A through eye exam that includes a binocular vision exam would find eye alignment problems most likely to cause ocular torticollis.  If treating a patient with torticollis of unknown cause, a binocular vision exam could be helpful in identify the problem. Frequently, prisms and lens can be prescribed that can help reduce the torticollis.

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Assessing Eye Movements

Assessing Eye Movements

Assessing eye movements should be a regular part of every therapists evaluation process. We get 75% of the information about our environment from vision and vision affects things like reading, handwriting and balance.

Before starting this evaluation, ask about the patients most recent eye exam. A patient not in best corrected visual acuity may have difficult time fixating and therefore show poor ocular motor skills. Every child needs a compete

Nystagmus

An involuntary movement of the eyes, called a nystagmus.  These are described as a congenital or acquired nystagmus and further described as jerky (faster in one direction than the other) or pendular (same speed in each direction).

Congenital Nystagmus

Assessing Eye Movements

Assessing eye movements is quick and easy and gives the therapist vital information on about the patient may be seeing the world . Its easy to do…just watch!!!

 

 

Learn More

Learn more about this subject in a live course and webinar presented by Robert. Hosted by PESI Education

About the Author