Purchase this article with an account.
B. Morris, V. Smith, J. Elphick, D.E. Laws; Does Compensatory Head Posture Due to Nystagmus Lead to Long Term Neck Problems and Adversely Effect Quality of Life? . Invest. Ophthalmol. Vis. Sci. 2005;46(13):2938.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose:Anecdotal evidence supports an increased incidence of neck problems in patients with compensatory head posture due to nystagmus. This study investigates whether this is true, and surveys Ophthalmologists on their opinions with regard to this. Methods: A case–controlled study was carried out to assess the range of neck movements in patients with compensatory head posture due to nystagmus. Patients with known neck problems, vertebro–basilar insufficiency and under 16 years were excluded. An inclinometer, which is a validated clinical tool, was used to assess neck movements. Disability and quality of life were scored with the American Academy of Orthopaedic Surgeon’s Cervical Spine Questionnaire. One hundred and fifty Ophthalmic Consultants throughout the U.K. were surveyed via a postal questionnaire. Results:55% of Consultants believe a compensatory head posture due to nystagmus leads to long–term neck problems, 37% believe it does not and 8% are undecided. 46% of Consultants have experience of patients with long–term neck problems due to nystagmus. 84% are influenced in their decision to operate by the presence of a compensatory head posture. The range of motion in these patients (n= 20) was statistically limited when compared to matched controls especially for right lateral flexion (p=0.001), left lateral flexion (p=0.001) and extension (p=0.003). However despite limited movement patients did not perceive a disability. Conclusions: Although varying opinions are held by Ophthalmologists with regard to the impact of a compensatory head posture on neck function, we have demonstrated that significant restriction in neck movements exists in nystagmus patients with this adaptive mechanism.
This PDF is available to Subscribers Only