OCULAR MANIFESTATIONS OF PLAGIOCEPHALY

Title OCULAR MANIFESTATIONS OF PLAGIOCEPHALY
Author, Co-Author Kathleen Zinzer, Michael Rouse
Topic
Year
1994
Day
Sunday
Program Number
Poster 25
Room
Convention Ctr Exhibit Hall
Affiliation
Abstract Plagiocephaly is a malformation of the skull caused by premature closure of a single cranial suture. Resultant cranial manifestations include flattening of the forehead and shortening of the orbital roof on the affected side with compensatory skull growth on the contralateral side. Facial asymmetry results, with the affected side appearing larger and concave, while the compensatory side appears smaller and convex when referenced to the midline. The affected side superior oblique muscle's function is reduced by the shortening of the orbital roof. The clinical presentation is an apparent affected side muscle palsy and ocular torticollis. A 13 year old male presented with the chief complaint of long-standing decreased vision in the right eye. The ocular history included spectacle wear for two years but no occlusion therapy. Medical history was unremarkable, although with observation a moderate plagiocephaly was apparent. The affected side was the left and the compensated side was the right. Early childhood pictures confirmed the long-standing cranial abnormality. Facial asymmetry and a right head tilt were present. Ocular complications included ptosis, constant right exotropia and hypotropia, significant anisometropic hyperopic astigmatism, deep amblyopia with eccentric fixation, and paradoxical anomalous correspondence Type I. Classic ocular manifestations of plagiocephaly are reported in the eye on the same side of the prematurely closed cranial suture. It is of interest that this patient's compensatory side (RE) was strabismic, rather than the expected left eye on the affected side. The anisometropia may have shifted dominance to the left eye, thus producing a hypotropia of the compensated side (right eye) instead of a hypertropia of the affected side (left eye). This patient presented with an interesting exception to classical reports of plagiocephaly. The important clinical implication is that plagiocephaly is an important differential diagnosis in p
Affiliation of Co-Authors
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