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Evaluation of the Bielschowsky Head-Tilt Test

Evaluation of the Bielschowsky Head-Tilt Test Abstract Tilting of the head as an aid in diagnosis of paretic vertical muscles is based on the theory that torsional action of the vertical muscles maintains the vertical meridians of the eyes erect when the head is tilted to the side. Since rotation of the optic disc about the macula occurs in the same direction, approximately to the same degree as the head is tilted, torsion as a normal function of the vertical ocular muscles is challenged. In differentiating between paresis of a superior oblique muscle or the superior rectus of the opposite eye, since paresis of either muscle in diagnostic problem cases will usually demonstrate a positive test for both muscles, tilting of the head as a diagnostic procedure is unreliable and often misleading. References 1. Bielschowsky, A.: Lectures in Motor Anomalies , Hanover, N.H.: Dartmouth College Publications, 1943, p 75. 2. Adler, F.H.: Physiology of the Eye: Clinical Application , ed 4, St. Louis: C. V. Mosby Co., 1965, pp 534-535. 3. Hewitt, R.S.: Torsional Eye Movements , Amer J Ophthal 34:253-260 ( (Feb) ) 1951. 4. Locke, J.C.: Heterotopia of the Blind Spot in Ocular Vertical Muscle Imbalance , Amer J Ophthal 65:362-374 ( (March) ) 1968. 5. Fink, W.H.: Surgery of the Vertical Muscles of the Eye , ed 2, Springfield, Ill: Charles C Thomas, Publisher, 1962, p 236. 6. Parks, M.M.: Isolated Cyclovertical Muscle Palsy , Arch Ophthal 60:1027-1035 ( (Dec) ) 1958.Crossref 7. Von Noorden, G.K., and Maumenee, A.E.: Atlas of Strabismus , St. Louis: C. V. Mosby Co., 1967, p 18B. 8. White, J.W.: The Choice of the Fixating Eye in Paralytic and Nonparalytic Strabismus , Amer J Ophthal 27:817-819 ( (Aug) ) 1944. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Evaluation of the Bielschowsky Head-Tilt Test

Archives of Ophthalmology , Volume 82 (4) – Oct 1, 1969

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Publisher
American Medical Association
Copyright
Copyright © 1969 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1969.00990020435002
Publisher site
See Article on Publisher Site

Abstract

Abstract Tilting of the head as an aid in diagnosis of paretic vertical muscles is based on the theory that torsional action of the vertical muscles maintains the vertical meridians of the eyes erect when the head is tilted to the side. Since rotation of the optic disc about the macula occurs in the same direction, approximately to the same degree as the head is tilted, torsion as a normal function of the vertical ocular muscles is challenged. In differentiating between paresis of a superior oblique muscle or the superior rectus of the opposite eye, since paresis of either muscle in diagnostic problem cases will usually demonstrate a positive test for both muscles, tilting of the head as a diagnostic procedure is unreliable and often misleading. References 1. Bielschowsky, A.: Lectures in Motor Anomalies , Hanover, N.H.: Dartmouth College Publications, 1943, p 75. 2. Adler, F.H.: Physiology of the Eye: Clinical Application , ed 4, St. Louis: C. V. Mosby Co., 1965, pp 534-535. 3. Hewitt, R.S.: Torsional Eye Movements , Amer J Ophthal 34:253-260 ( (Feb) ) 1951. 4. Locke, J.C.: Heterotopia of the Blind Spot in Ocular Vertical Muscle Imbalance , Amer J Ophthal 65:362-374 ( (March) ) 1968. 5. Fink, W.H.: Surgery of the Vertical Muscles of the Eye , ed 2, Springfield, Ill: Charles C Thomas, Publisher, 1962, p 236. 6. Parks, M.M.: Isolated Cyclovertical Muscle Palsy , Arch Ophthal 60:1027-1035 ( (Dec) ) 1958.Crossref 7. Von Noorden, G.K., and Maumenee, A.E.: Atlas of Strabismus , St. Louis: C. V. Mosby Co., 1967, p 18B. 8. White, J.W.: The Choice of the Fixating Eye in Paralytic and Nonparalytic Strabismus , Amer J Ophthal 27:817-819 ( (Aug) ) 1944.

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Oct 1, 1969

References