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Mechanisms for Positive Bielschowsky Head Tilt Testing in Horizontal Strabismus.

Ayman M ElghonemyFadia S AttiaMichael C Brodsky
Published in: Journal of binocular vision and ocular motility (2024)
Exotropia and esotropia produce hyperdeviations during BHTT testing, with a hyperdeviation on the side of the tilt observed in patients with exotropia, and hypotropia on the side of the tilt observed in patients with esotropia. These diametrical results are not attributable to any preexistent alteration of neurologic output inherent to these two forms of horizontal strabismus or to associated torsion. Rather, they arise directly from the altered anatomical positions of the two eyes, which cause the eyes to approximate their visual axes more closely to the vertical rectus muscles (in exotropia) and the oblique muscles (in esotropia), enabling the vertical actions of specific cyclovertical muscles to predominate in response to altered utricular output generated by the BHTT.
Keyphrases
  • optical coherence tomography
  • optic nerve
  • cataract surgery