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Dr. Stan
Dr. Stan, Ophthalmologist
Category: Eye
Satisfied Customers: 2701
Experience:  Johns Hopkins Fellowship Trained, Certified and Licensed Medical Physician and Surgeon
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My daughter has strabismus and has had surgery and now glasses.

Resolved Question:

My daughter has strabismus and has had surgery and now glasses. She tilts her head and often "shakes" her head back and forth. She is two. Her doctor has no input for the potential reason for the head movement. Any advice?
Submitted: 7 years ago.
Category: Eye
Expert:  Dr. Stan replied 7 years ago.
Hello,

Welcome to Just Answer:

Did the head shake/tilt start after the surgery, or has it been there before the surgery?

I await your reply.
Customer: replied 7 years ago.
I noticed it months after surgery. It started in a more subtle fashion, but now it has worsened. It is most obvious as she watches television or fixates on something. It is not "jerky" but more of a controlled, constant, side to side motion.
Expert:  Dr. Stan replied 7 years ago.
Hello,

Thank you for your reply.

Your likely have either monofixation or eccentric fixation symptoms: With her very you age, she could re-adjust better with time.

The cause of such problem is the due to the strabismus, her vision in the lazy eye is less, and so she is not able to have perfect depth or stereovision (called monofixation syndrome). So, when watching the TV she is constant trying to shift her head side to side to better appreciate the position or depth of the image in view. It is also possible, that the strabismus caused the center line of focus of your daughter's eye to shift slightly (called eccentric fixation). With the deviated present, the line of focus at the back of formed. However, after the correction of the deviated eye, the line of focus which was previously registered in the brain has not completely re-adjusted. So, to compensate and prevent seeing double or distorted image, she tends to shift her head position.

I suggest that you ask her doctor to evaluate her for monofoxation syndrome and/or eccentric fixation syndrome. If not improved, at later age there could be eye exercises (when she is able to follow instruction which may help her adjust to the condition better). It is also quite possible that she will out grow some of it and re-adjust better since her eyes are still developing.

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