Surgical Outcome of Nystagmus Inducing Head Tilt: Three Cases

Jeong, Young Hwan; Jeon, Hyeshin; Choi, Hee Young

Case Report

Annals of Optometry and Contact Lens 2019;18(4):131-135.
Published online December 25, 2019.

고개 기울임을 유발하는 영아 눈떨림의 수술 3예

정영환, 전혜신, 최희영

부산대학교 의과대학 안과학교실¹,
부산대학교병원 의생명연구소²

Surgical Outcome of Nystagmus Inducing Head Tilt: Three Cases

Young Hwan Jeong, Hyeshin Jeon, Hee Young Choi

Department of Ophthalmology, Pusan National University School of Medicine¹, Busan, Korea
Biomedical Research Institute, Pusan National University Hospital², Busan, Korea

Received: 1 November 2019 • Revised: 8 November 2019 • Accepted: 11 November 2019

Abstract

Purpose: To report surgical outcome in three patients with abnormal head tilting position induced by nystagmus.
Case summary: (Case 1) A 7-year-old female patient diagnosed with Down's syndrome visited our clinic for right head tilting, chin up and nystagmus. Abnormal ocular deviation was not found. Bilateral inferior rectus recession and superior rectus resection, right superior oblique anterior half tenectomy, left inferior oblique recession were performed. Abnormal head position was improved after surgery. (Case 2) A 7-year-old female patient presenting nystagmus with left head tilting, esotropia and right hypertropia visited our clinic. Right medial rectus recession and right inferior oblique recession, left superior oblique muscle anterior half tenotomy were performed. While head tilting was improved immediately after surgery, right head tilt and left hypertropia were observed after 2 years. Left superior rectus central mini-tenotomy and superior oblique re-attachment of primarily cut-out fiber were performed. After surgery, right head tilting and left hypertropia has decreased. (Case 3) A 3-year-old boy was presented with right face turn and left head tilting with nystagmus. Right medial rectus recession and inferior oblique recession, left lateral rectus recession and superior oblique anterior partial tenectomy were performed. Postoperative head position was improved and strabismus was not found.
Conclusions: Abnormal head position was improved after surgery in three patients who have nystagmus causing abnormal head tilting. Oblique muscle surgery for nystagmus may have good result for correcting abnormal head position.

Key Words: Abnormal head position; Head tilting; Nystagmus; Oblique extraocular muscles