scholarly journals Does Decreased Static Ocular Counter Rolling Account for Bielschowsky Head Tilt Test in Unilateral Superior Oblique Palsy?

2017 ◽  
Vol 58 (10) ◽  
pp. 4268 ◽  
Author(s):  
Da Ye Diana Choi ◽  
Soo Min Lee ◽  
Kyung Ah Park ◽  
Sei Yeul Oh
Keyword(s):  
Head Tilt ◽  
Tilt Test ◽  
Superior Oblique Palsy ◽  
Superior Oblique

scholarly journals Bielschowsky head-tilt test—I. Ocular counterrolling and Bielschowsky head-tilt test in 23 cases of superior oblique palsy

1985 ◽  
Vol 25 (12) ◽  
pp. 1977-1982 ◽  
Author(s):  
H.J. Simonsz ◽  
R.A. Crone ◽  
J. van Der Meer ◽  
C.F. Merckel-Timmer ◽  
A.M. van Mourik-Noordenbos
Keyword(s):  
Head Tilt ◽  
Tilt Test ◽  
Superior Oblique Palsy ◽  
Ocular Counterrolling ◽  
Superior Oblique

scholarly journals Vertical Strabismus and Positive Bielschowsky Head-Tilt Test: Atypical Presentation of a Maxillary Mucocele

2021 ◽  
Author(s):  
Filipe André Correia ◽  
Gustavo Filipe Antunes de Almeida ◽  
Carolina Fernandes Pereira Bruxelas ◽  
Pedro Alberto Batista Brissos de Sousa Escada
Keyword(s):  
Head Tilt ◽  
Visual Disturbance ◽  
Oblique Muscle ◽  
Tilt Test ◽  
History Of ◽  
Vestibular Symptoms ◽  
Binocular Diplopia ◽  
Superior Oblique Muscle ◽  
Cover Test ◽  
Superior Oblique

AbstractTest of skew has become a cornerstone in the approach of a patient with vestibular symptoms but a detected vertical misalignment may be caused by an oculomotor disturbance and not a skew deviation. We report the case of an elderly patient with a 1-month history of dizziness and visual disturbance that revealed on bedside examination a spontaneous left head-tilt and a pathologic alternate cover test, with right eye hypertropia and excyclotorsion, worse with right head-tilt. Dizziness was assumed to have a visual origin with unrecognized binocular diplopia, caused by an acquired right eye superior oblique muscle palsy. However, imaging revealed a right maxillary mucocele that eroded the orbit floor into the orbit. The change of the intraorbital component of the maxillary fluid-filled mass with head-tilt through a dehiscent orbital floor may explain the findings of vertical strabismus and positive Bielschowsky head-tilt test in this case. Endoscopic treatment improved symptoms and findings.

Perinatal Head Tilt in Congenital Superior Oblique Palsy

2009 ◽  
Vol 29 (1) ◽  
pp. 76-77 ◽  
Author(s):  
Michael C Brodsky ◽  
Virginia Karlsson
Keyword(s):  
Head Tilt ◽  
Superior Oblique Palsy ◽  
Superior Oblique

Inferior oblique recession associated to partial temporal inferior rectus recession in unilateral congenital superior oblique palsy

2021 ◽  
pp. 112067212199766
Author(s):  
Barbara Burgos-Blasco ◽  
Elena Hernandez-Garcia ◽  
Carlos Llorente-La-Orden ◽  
Rosario Gomez-de-Liaño
Keyword(s):  
Head Tilt ◽  
Contralateral Side ◽  
Superior Oblique Palsy ◽  
Inferior Rectus ◽  
Primary Position ◽  
Female Age ◽  
Vertical Deviation ◽  
Inferior Oblique Recession ◽  
Age Range ◽  
Superior Oblique

Purpose: To evaluate the effectiveness of inferior oblique recession with contralateral partial temporal inferior rectus recession in patients with decompensated congenital unilateral superior oblique palsy (SOP) in correcting moderate vertical deviations in primary position. Methods: The medical records of patients with SOP who underwent inferior oblique recession with contralateral partial temporal inferior rectus recession were reviewed retrospectively. Vertical deviation in primary position, subjective torsion, diplopia, residual deviation, and the deviation decrease were evaluated. Results: Four patients (three males and one female, age range 29–56 years) with congenital unilateral SOP and mean vertical deviation of 21.0 ± 5.3PD (range 14–25D) in primary position were included. Mean correction of hypertropia in primary position with this technique was 15.5 ± 5.3PD (range 10–20PD). The mean hypertropia on gaze to the contralateral side changed from 30.0 ± 10.8D before surgery to 9.3 ± 7.9D after surgery. Torsion had a mean change of 4.8° of incyclodeviation. Preoperatively, all patients had head tilt and diplopia, which was resolved in all but one patient, who will need surgery. Patients were followed an average of 18 months. No adverse events were reported in any subjects. Conclusion: When performing recession of inferior oblique muscles in SOP associated to a full recession of the contralateral inferior rectus, there is a risk of overcorrection in those with moderate angles. Performing a partial recession in the contralateral inferior rectus eye corrected up to 20PD in primary position in our series, reducing this risk.

scholarly journals Decompensated Superior Oblique Palsy Secondary to Bilateral Nutritional Optic Neuropathy Following Bariatric Surgery

2021 ◽  
pp. 1008-1013
Author(s):  
Eleanor Nche ◽  
Ravid Ben-Avi ◽  
Ari Shemesh ◽  
Joshua M. Kruger
Keyword(s):  
Bariatric Surgery ◽  
Optic Neuropathy ◽  
Vision Loss ◽  
Visual Fields ◽  
Head Tilt ◽  
Nutritional Supplements ◽  
Nutritional Deficiencies ◽  
Superior Oblique Palsy ◽  
Primary Position ◽  
Superior Oblique

Optic neuropathy can occur secondary to nutritional deficiencies in patients who have undergone bariatric surgery. We present a unique case of a 39-year-old man, claiming to be generally healthy, who presented with intermittent vertical diplopia and bilateral decreased vision in each eye. Visual acuity was 6/18 in the right eye and 6/12 in the left eye. Ishihara testing was defective for both eyes. Automated visual fields showed a severe generalized reduction in sensitivity in both eyes. The patient had a left head tilt and a right intermittent hypertropia of 30 prism diopters in primary position. CT of the orbits revealed a right superior oblique of small caliber. On further questioning, the patient admitted to a history of bariatric surgery 7 years prior to presentation with failure to take any nutritional supplements. Blood work demonstrated deficiencies in folate, thiamine, and copper. Within 6 months of initiating nutritional supplements, the vision in each eye was markedly improved and the diplopia resolved. There was an associated normalization of thiamine and copper, but folate levels remained low. We believe that the nutritional deficiency caused a bilateral optic neuropathy and the resulting vision loss precipitated a manifestation of a congenital superior oblique palsy that had previously just been a phoria. The case emphasizes the importance of considering occult sensory etiologies of acquired strabismus.

scholarly journals Paradoxical head tilt in unilateral traumatic superior oblique palsy

2017 ◽  
Vol 29 (3) ◽  
pp. 221-223
Author(s):  
Mohammad Reza Akbari ◽  
Reza Bayat ◽  
Arash Mirmohammadsadeghi ◽  
Reza Mirshahi
Keyword(s):  
Head Tilt ◽  
Superior Oblique Palsy ◽  
Superior Oblique
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