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Curbside Consultation in Neuro-Ophthalmology

  This continuing medical education activity is sponsored by Vindico Medical Education.


Original Articles
Relationships Between Visual Acuity and Anomalous Head Posture in Patients With Congenital Nystagmus
Journal of Pediatric Ophthalmology and Strabismus   Vol. 40   No. 5   September/October 2003
Deanna J. Stevens, MD and Richard W. Hertle, MD
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PURPOSE

To determine whether patients with congenital nystagmus and an anomalous head posture have better binocular visual acuity than such patients without an anomalous head posture.

PATIENTS AND METHODS

This was an observational case series of prospectively collected data for 125 patients with clinical and oculographically confirmed congenital nystagmus. Clinical data were tabulated using computer software. Statistical analyses compared binocular visual acuity with and without the presence of a clinically evident anomalous head posture and visual acuity with and without associated sensory disease.

RESULTS

The mean visual acuity was 20/42 (log of the minimal angle of resolution [MAR], 0.32) in patients with an anomalous head posture and 20/83 (logMAR, 0.62) in patients with no anomalous head posture (P < .001). Among patients with disease of the sensory system, those with an anomalous head posture had a mean visual acuity of 20/55 (logMAR, 0.44) and those without an anomalous head posture had a mean visual acuity of 20/108 (logMAR, 0.73; P < .001).

CONCLUSIONS

Visual acuity was found to be significantly better in patients with congenital nystagmus who had an anomalous head posture versus those without such a head posture. Our findings indicate that the presence of an anomalous head posture in a patient with congenital nystagmus correlates with good vision and thus may be considered a positive prognostic sign in a preverbal child.

J Pediatr Ophthalmol Strabismus 2003;40:259-264

AUTHORS

The authors are from the Laboratory of Visual and Ocular Motor Physiology and the Departments of Ophthalmology, Columbus Children’s Hospital and The Ohio State University, Columbus, Ohio.

Originally submitted December 4, 2002.

Accepted for publication February 4, 2003.

Address reprint requests to Richard W. Hertle, MD, Pediatric Ophthalmology Associates, Inc., Children’s Hospital of Columbus, 555 S. 18th Street, Suite 4C, Columbus, OH 43205.

Presented at the Annual Meeting of the American Association for Pediatric Ophthalmology and Strabismus; March 23-27, 2003; Kamuela, Hawaii.

The authors have no industry relationships to disclose.

In accordance with ACCME policies, the audience is advised that this continuing medical education activity may contain references to unlabeled uses of FDA-approved products or to products not approved by the FDA for use in the United States. The faculty members have been made aware of their obligation to disclose such usage.

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