What is an abnormal head posture?
An abnormal head position occurs when the head is deviated out of the primary, straight ahead, position while the eyes look eccentrically at a target of interest. This can include chin up, chin down, tilting of the head to the right or left, face turns to the right or left, or a combination of any of these. This can happen due to ocular or non-ocular cause.
What are some of the ocular causes of an abnormal head position?
Eye misalignment or squint
Nystagmus: Some patients with nystagmus (jerky eye movements) will acquire a head turn or tilt if the nystagmus slows down in a certain gaze or head position.
Difference in vision between the eyes
Ptosis:Chin up position to help lift the lids.
Refractive errors
Habitual or Unknown cause
Can my child see when the head is in an abnormal position?
Yes, most children adopt a head posture to improve their vision if the head turn is from an ocular cause.
Can a longstanding head turn lead to any permanent problems?
Yes, a significant abnormal head posture could cause permanent tightening of neck muscles that can lead to chronic neck ache or headache. An abnormal head posture may also cause the facial bones to grow abnormally leading to facial asymmetry.
What are some of the non-ocular causes of an abnormal head position?
Congenital torticollis
Skull deformities such as plagiocephaly
Other non-ocular causes include Cerebral palsy, Bony abnormalities, Craniosynostosis and unilateral hearing loss
A patch test on an outpatient basis can also confirm the diagnosis. If the head tilt is due to tight neck muscles, then the tilt will remain the same with the patch on. If the head tilt is from an ocular cause such as strabismus (Squint), then the tilt should get better when the patch is on.
Are there any treatments for abnormal head posture?
Yes
Surgical procedures are available for treatment of head postures related to strabismus (Squint), nystagmus and ptosis. Glasses for refractive errors and patching therapy for an eye with weaker vision (amblyopia) are available.
Physical therapy helps in causes associated with neck problem.
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