[Abnormal head position caused by incorrect prescription for astigmatism: case report].
Abnormal head position is a compensatory condition which improves patients' vision. It can be caused by ophthalmological problems such as oculomotor imbalances (strabismus, nystagmus) and high astigmatism. However, it results in esthetic impairment, orthopedic trouble and facial asymmetries. We describe a case of a girl, JL, 8 years, with abnormal head position tilted to the left since the last glasses were prescribed. The correction used by the patient was: right eye = +2.00 sph diopter -5.5 cyl 180 degrees and left eye = +2.25 sph diopter -5.75 cyl 180 degrees. In tilted position, the correct visual acuity was: right eye 6/12 and left eye 6/9. No deviations were noted by the cover test and the remaining ophthalmological examination was completely normal. Retinoscopy under cycloplegia and subjective test showed right eye = +3.50 sph diopter -6.00 cyl 10 degrees; and left eye = +3.50 sph diopter -6.00 cyl 170 degrees, with visual acuity 6/6 in both eyes. With adequate prescription, the head position was normalized. Wrong cylindrical positions for correction of high astigmatism may cause abnormal head position. Retinoscopy under cycloplegia and subjective test are essential for precise diagnoses and prescriptions.
Castro
Flávia Augusta Attié de
FA
Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP.
Simão
Maria Lúcia Habib
ML
Abbud
Christine Mae Morello
CM
Foschini
Rosália Maria Simões Antunes
RM
Bicas
Harley Edison Amaral
HE
D001251:Astigmatism / Q000534:rehabilitation*; D002648:Child; D003951:Diagnostic Errors / Q000009:adverse effects; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D006257:Head; D019416:Head Movements; D006801:Humans; D007909:Lenses; D011187:Posture; D014792:Visual Acuity