Clinical features of pediatric ocular torticollis in Dakahlia Governorate, Egypt

Document Type : Original Articles

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Mansoura Ophthalmic Center, Mansoura University

Abstract

Purpose: To determine the relative frequency of the most common ocular causes and types of torticollis in pediatric patients presented with abnormal head posture (AHP) attending pediatric ophthalmology and strabismus clinic of MOC.
Method: A descriptive cross sectional study has been done. A total of 300pediatric patients presented with abnormal head posture attending pediatric ophthalmology and strabismus clinic of Mansoura Ophthalmic Center underwent complete ophthalmologic examination. Demographic and orthoptic findings were recorded.
Results: Among the 300patients there were 159females (53%) and 141males (47%)with a median age 7years (range 6months to 18years). Head tilt was the most common AHP pattern observed in (68.7%)followed by combined variety in (14.7%)then face turn position in (12.3%)and finally abnormal chin position in(4.3%). The most common ocular causes of torticollis were superior oblique palsy (SOP) in (60%), dissociated vertical deviation (DVD) in (10%),Duane syndrome in (7%)and nystagmus in(5%). Amblyopia was detected in 115(38.3% of examined patients). Lang test was negative even while adopting the AHP in (26%)of examined patients.
Conclusion: Our study has revealed a wide variety of AHP patterns, causes and clinical features among pediatric patients presented with torticollis. Head tilt was the most common AHP pattern in our study.Different patterns of AHP can occur in patients with the same diagnosis. Superior oblique palsy, DVD,Duane retraction syndrome and nystagmus were the commonest causes of AHP in our study cohort. Amblyopia and defective binocular vision represented a great concern in our study. A population-based study is recommended for better evaluation of ocular torticollis among egyptian population.

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