Ocular-induced abnormal head postures: A systematic review and analysis

Abnormal head postures (AHPs) are frequently adopted as compensatory mechanisms by individuals affected by various ocular diseases to optimize the utilization of their visual field or alleviate symptoms such as diplopia. We review the causal relationship between ocular diseases and the resulting AHPs. An extensive literature search was conducted to identify and summarize relevant medical studies providing evidence of AHPs in patients diagnosed with conditions like Duane retraction syndrome, Brown syndrome, superior oblique palsy, and other ocular disorders. The analysis explores the proportion of AHP types (head tilt, turn, chin-up/down) and the frequency distribution of ocular conditions for each studied disease. In addition, the degrees of ocular misalignment (hypertropia, hypotropia, esotropia, exotropia) associated with specific AHP manifestations are quantified. Key properties of ocular misalignment and AHPs across different diseases are examined, and Cramer's V statistical measure is employed to assess the association between diseases, AHPs, and ocular misalignment. The findings highlight the need for comprehensive datasets encompassing diverse ocular diseases to support the development of robust artificial intelligence models capable of accurately diagnosing AHPs. This study contributes an in-depth understanding of the mechanisms underlying AHPs and provides a foundation for advancing diagnostic and rehabilitation strategies in vision sciences.