Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada; Ophthalmology and Vision Sciences, Hospital for Sick Children, Toronto, Ontario, Canada. Electronic address: [Email]
Torsional augmentation surgery was used to correct the anomalous head position (AHP) in a child with congenital ocular tilt reaction (OTR). The underlying neuropathology was hypoplasia involving the right hemicerebellum and contralateral brainstem. Postoperatively there was an acceptable and variable resolution of head tilt sustained over a 25-year follow-up period. These findings suggest that early torsional augmentation surgery can effectively correct stable OTR head tilt in congenital cases over the long term.