Abnormal Head Position

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WHAT IS AN ABNORMAL HEAD POSITION?

This is when the head is not straight when focusing. The head can be with the chin up or down, titled right or left, the face turned right or left, or a mixture of any of these. The cause can be an eye problem, or not due to the eyes at all.  
 

WHAT EYE PROBLEMS CAUSE AN ABNORMAL HEAD TILT?

1) Crossed eyes (strabismus): When a child has crossed eye(s), how much the eye crosses will change when the child is looking in different directions. The child will put their head in a spot where the eyes cross the least. This will help with double vision and eye strain.
2) Shaky eyes (nystagmus): Sometimes a child’s eyes can shake.  When this happens the child may tilt or turn their head because it slows down or stops the eye shaking and helps the child see better.
3) Difference in vision between the eyes (anisometropia): If a child sees better in one eye than the other, they might turn their head. This brings what they are looking at closer to the better eye and helps them see better. 
4) Droopy eyelid (ptosis): A child with a droopy eyelid might lift or tilt their chin. This helps the eyes look “under” the droopy eyelid and see better.
5)Need for glasses (refractive error):  When a child needs glasses to see better, they might turn their head to help them see better when they don’t have glasses on. 
 

CAN MY CHILD SEE WHEN THE HEAD IS IN AN ABNORMAL POSITION?

Yes, when the cause of the head tilt or turn is an eye problem, most children use that head turn to see better. It is important not to correct the head tilt or turn until the cause can be fixed so that the child can keep seeing well.
 

CAN A LONGSTANDING HEAD TURN LEAD TO ANY PERMANENT PROBLEMS?

Yes, abnormal head position may cause neck pain and headache. It may also cause the bones of the face to grow different from each other. 
 

WHAT ARE SOME CAUSES OF A HEAD TILT OR TURN NOT DUE TO AN EYE PROBLEM?

If a child is born with shorter neck muscles, this can cause a head tilt. Other causes of a head tilt are problems moving muscles, having neck bones that do not join normally, and hearing loss in one ear. 
 

HOW CAN YOU TELL WHETHER THE CAUSE OF A HEAD TILT IS AN EYE PROBLEM OR NOT?

An ophthalmologist (eye doctor/surgeon) will do a full eye check-up to look for eye problems that can cause a head tilt or turn. Sometimes, a patch can be placed on one of the eyes to see if this helps the abnormal head position and if the head tilt is being caused by an eye problem. 
 

ARE THERE ANY TREATMENTS FOR A HEAD TILT OR TURN?

Yes.  There are different treatments that can help an abnormal head position, depending on the cause. Sometimes an operation, glasses or a patch can help in cases due to eye problems.  An operation can be helpful when the eyes are crossed (strabismus) or shaky (nystagmus), or when the eyelid is droopy (ptosis). Glasses and patching can help when there is an eye with weak vision (amblyopia). 
Physical therapy can help when the cause of the head tilt or turn is short, tight neck muscles.  

Updated 10/2023


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