This is a retrospective study from Korea, of 118 patients’ charts with intermittent exotropia (IXT) and divided into two groups; 50 patients showed positive Bielchowsky head tilt test (BHTT) and 68 with negative BHTT. Significant differences (p<0.05) in the parameters including the elapsed time from the onset of IXT, the exodeviation angle for distance, inferior oblique overaction, vertical deviation at primary deviation, suppression and stereoacuity between the two groups. Only horizontal muscle surgery performed in the BHTT positive group without cyclovertical muscle surgery, resulted in a marked decrease in the number of patients in the BHTT group. The authors concluded that in the BHTT positive group, the BHTT could be eliminated without inferior oblique weakening procedure.

Intermittent exotropia with a positive Bielchowsky head-tilt test.
Lee TH, Ji YS, Park SW, et al.
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Jonathan Chan

Royal Hallamshire Hospital, Sheffield, UK.

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