DVD Remains a Moving Target!

Abstract

In this extension of my original treatise, I address the clinical phenomenology of DVD. This analysis has stood the test of time. Occasionally, DVD can manifest as an enigmatic head tilt following strabismus surgery for infantile esotropia. The known mechanisms by which DVD can be accompanied by a head tilt are summarized in the following figure. Although the diagram depicts clear dichotomies, it often remains difficult if not impossible to categorically assign a distinct cause to the torticollis in any given patient (Fig. 2.1). The tug-of-war between the need for binocular fusion and the need for vertical orientation may explain the absence of torticollis in most patients with DVD.