Torsional augmentation for the treatment of lateropulsion and torticollis in partial ocular tilt reaction

Purpose: We describe a new surgical treatment for lateropulsion and torticollis arising from an ocular tilt reaction. Methods: Visual sensory parameters and postural abnormalities were retrospectively reviewed in a patient with a partial ocular tilt reaction who was treated with horizontal transposition of the vertical rectus muscles to surgically augment preexisting binocular torsion. Results: Torsional augmentation eliminated the sensation of lateropulsion and produced almost complete resolution of her torticollis and associated body tilt. Conclusions: Binocular torsional augmentation can be used to reduce both lateropulsion and torticollis in the setting of an ocular tilt reaction.