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Development of a questionnaire to identify ocular torticollis

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Abstract

Ocular disease is one of the causes of abnormal head positioning. Conventionally, the behavioral characteristics of ocular torticollis patients are different from those of non-ocular torticollis patients, though research addressing the significance of this difference is yet limited. This prospective, cross-sectional study aims to develop a questionnaire based on the clinical features in children with abnormal head posture being ocularly assessed. Children aged ≥ 6 months who visited our rehabilitation medicine clinic with a chief complaint of abnormal head posture were included. Patients with apparent orthopedic and neurological diseases were excluded. A 10-item questionnaire was developed to analyze the behavioral characteristics of patients. The patients were divided into ocular and non-ocular torticollis groups according to ophthalmologic examination results. Thirty-four and 13 patients were assigned to the non-ocular torticollis and ocular torticollis groups, respectively. Five questions were finally selected and the questionnaire was scored as the sum of the scores for the each questions (yes = 1 point, no = 0 point). The median (interquartile range) score of the ocular torticollis group (3.0 (3.0–4.0)) was significantly higher than that of the non-ocular torticollis group (2.0 (1.0–3.0); p = 0.000).

Conclusion: Our parent-reported torticollis assessment questionnaire may be useful for screening ocular torticollis.

What is known:

• Ocular disease is one of the various causes of abnormal head positioning.

• The behavioral characteristics of patients with ocular torticollis are different from those of patients with non-ocular torticollis; research on this matter is limited.

What is new:

• We delveloped a questionnaire to differentiate ocular and postural torticollis and the score of the questionnaire was different between patients with or without ocular disease.

• The questionnaire based on behavioral characteristics may help screening and determining the need of ophthalmic evaluation in patients with torticollis.

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Abbreviations

ROC:

Receiver operation characteristic

AUC:

Area under curve

SE:

Standard error

CI:

Confidence interval

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Acknowledgments

The authors gratefully acknowledge Jinmi Kim (Department of Biostatistics, Biomedical Research Institute, Pusan National University hospital) for providing helpful comment of statistical analysis.

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Authors and Affiliations

  1. Department of Rehabilitation Medicine, Pusan National University School of Medicine, Busan, South Korea

    Jin A. Yoon & Yong Beom Shin

  2. Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea

    Jin A. Yoon, Heeyoung Choi, Yong Beom Shin & Hyeshin Jeon

  3. Department of Ophthalmology, Pusan National University Hospital, Busan, South Korea

    Heeyoung Choi & Hyeshin Jeon

Authors
  1. Jin A. Yoon
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  2. Heeyoung Choi
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  3. Yong Beom Shin
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  4. Hyeshin Jeon
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Contributions

Research design: JAY, HYC, YBS, and HJ; data acquisition and research execution: JAY, HYC, YBS, and HJ; data analysis and interpretation: JAY and HS; manuscript preparation: JAY and HS.

Corresponding author

Correspondence to Hyeshin Jeon.

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The authors declare that they have no conflict of interest.

Ethical approval

This research protocol involving human participants and the protocol was approved by the Institutional Review Board (IRB)/Ethics Committee in Pusan National University hospital (approval number: 1802-024-074). This study complied with the principles of the Declaration of Helsinki.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Communicated by Gregorio Paolo Milani

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Yoon, J.A., Choi, H., Shin, Y.B. et al. Development of a questionnaire to identify ocular torticollis. Eur J Pediatr 180, 561–567 (2021). https://doi.org/10.1007/s00431-020-03813-2

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  • DOI: https://doi.org/10.1007/s00431-020-03813-2

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