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Surgical Outcome of Nystagmus Inducing Head Tilt: Three Cases
Ann Optom Contact Lens 2019;18:131-135
Published online December 25, 2019
© 2019 The Korean Optometry & Contact Lens Study Society

Young Hwan Jeong, MD1, Hyeshin Jeon, MD1,2, Hee Young Choi, MD, PhD1,2

Department of Ophthalmology, Pusan National University School of Medicine1, Busan, Korea
Biomedical Research Institute, Pusan National University Hospital2, Busan, Korea
Correspondence to: Hee Young Choi, MD, PhD
Department of Ophthalmology, Pusan National University Hospital, #179 Gudeok-ro, Seo-gu, Busan 49241, Korea
Tel: 82-51-240-7326, Fax: 82-51-240-7341
Received November 1, 2019; Revised November 8, 2019; Accepted November 11, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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.
Keywords : Abnormal head position; Head tilting; Nystagmus; Oblique extraocular muscles

December 2019, 18 (4)