Case Report Summary: How Treating a Child’s Vision Can Improve Head Tilt in Torticollis

The winter edition of the Vision Development and Rehabilitation Journal by the College of Optometrists in Vision Development, features a case report titled, An Interdisciplinary Approach to Improve Head Tilt in Pediatric Torticollis Patients with the Use of Prism Glasses, cowritten by Clarendon Vision’s Pediatric Specialist, Dr. Amber Cumings, FAAO and Pediatric Physical Therapist, Carla Pister, PT.

The article brings awareness to patients and medical professionals about how vision can be linked to head posture and the importance of including a functional vision assessment done by a Developmental Optometrist when assessing and treating head tilts.

Below is a synopsis of the case study which focused on a pediatric patient. However, head tilts can be a vision-related symptom, treatable by Dr. Cumings in patients of all ages.

Background
The case follows one pediatric patient who was initially diagnosed with torticollis (head tilt) and seen by Carla Pister, PT for physical therapy at age 2 years old. During the months of manual treatment, the patient’s head tilt persisted even with normal range of motion. Carla determined that a functional vision evaluation was warranted to rule out any eye misalignments that could be contributing to the persistent head tilt.

Vision Related Diagnosis and Treatment Using Prism Lenses
Upon completion of the initial functional vision assessment by Dr. Cumings, it was determined that the patient did indeed have an eye misalignment that she was compensating for by tilting her head. Glasses with advanced lens technology using Prism were prescribed to be worn full time. With continuing to wear the Prism glasses and attending physical therapy during the following months, the patient’s head tilt resolved and many gross and fine motor developmental milestones were achieved.


Long-Term Outcomes and Results

Over the next several years, visual demands changed for the patient (i.e. needing to start school and see things at a distance) and gross motor skills were subsequently affected. During those years, the patient went from near immobility to being able to use a wheelchair unassisted. With each new phase of growth, both visually and anatomically, the patient was reassessed by Dr. Cumings for glasses and the prescription was modified to adjust for the patient’s visual needs at the time.

Summary
This case study illustrates that glasses with the right advanced lens prescription can be an effective treatment option for patients that experience head tilts, when vision is the primary reason for the head tilt. Positive results can be seen almost immediately and which also help support better outcomes for other therapy interventions.

To speak to Dr. Cumings about whether vision is contributing to your child’s head tilt or a deficiency in any other developmental milestones, contact our office at (630) 323-7300 to schedule an appointment.

To access the full case report including Before and After photos and videos of treatment results, go to: https://cdn.ymaws.com/www.covd.org/resource/resmgr/vdr/vdr_7_4/vdr7-4_casereport_cumings_we.pdf

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