Skew Deviation and the Ocular Tilt Response

Update item information
Identifier DNT1.ppt
Title Skew Deviation and the Ocular Tilt Response
Creator David Newman-Toker, MD, PhD, Associate Professor, Departments of Neurology, Ophthalmology, & Otolaryngology, The Johns Hopkins University School of Medicine
Subject Vertical strabismus; Cyclovertical strabismus; Skew deviation; Vestibulo-ocular reflex; Ocular tilt reaction; Vestibular pathways; Vestibular ocular system
Description The objectives of this presentation are to provide an understanding of the current use of the terms "ocular tilt reaction" and "skew deviation," to create some familiarity with the anatomic and physiologic substrate of ocular tilt and skew, and to demonstrate how to distinguish between skew and isolated oblique palsies at the bedside, recognizing limitations in our understanding of cyclovertical palsies.
Anatomy utricle; vestibular nuclei; medial longitudinal fasciculus; MLF; interstitial nucleus of Cajal; INC; rostral interstitial nucleus of the MLF; riMLF; brainstem; medulla; pons; midbrain; superior oblique; inferior oblique; superior rectus; inferior rectus; oculomotor nucleus; trochlear nucleus
Clinical vertical strabismus; cyclovertical strabismus; ocular torsion; fundus torsion
Disease/Diagnosis skew deviation; ocular tilt response
Contributor Primary David Newman-Toker, M.D., Ph.D., Associate Professor Departments of Neurology, Ophthalmology, and Otolaryngology, The Johns Hopkins University School of Medicine
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Date 2005-11-16
Type Text
Format application/pdf
Relation is Part of Dr. Newman-Toker, University of Utah Neurology Grand Rounds
Rights Management Copyright 2005. For further information regarding the rights to this collection, please visit:
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Collection Neuro-ophthalmology Virtual Education Library: NOVEL
References 1: Brandt TH, Dieterich M. Different types of skew deviation. J Neurol Neurosurg Psychiatry. 1991 Jun;54(6):549-50. PMID: 1880519 [PubMed - indexed for MEDLINE] 2: Brodsky MC. Three dimensions of skew deviation. Br J Ophthalmol. 2003 Dec;87(12):1440-1. No abstract available. PMID: 14660447 [PubMed - indexed for MEDLINE] 3: Demer JL. Clarity of words and thoughts about strabismus. Am J Ophthalmol. 2001 Nov;132(5):757-9. No abstract available. PMID: 11704038 [PubMed - indexed for MEDLINE] 4: Donahue SP, Lavin PJ, Mohney B, Hamed L. Skew deviation and inferior oblique palsy. Am J Ophthalmol. 2001 Nov;132(5):751-6. PMID: 11704037 [PubMed - indexed for MEDLINE] 5: Donahue SP, Lavin PJ, Hamed LM. Tonic ocular tilt reaction simulating a superior oblique palsy: diagnostic confusion with the 3-step test.Arch Ophthalmol. 1999 Mar;117(3):347-52. PMID: 10088812 [PubMed - indexed for MEDLINE] 6: Halmagyi GM, Gresty MA, Gibson WP. Ocular tilt reaction with peripheral vestibular lesion.Ann Neurol. 1979 Jul;6(1):80-3. PMID: 315752 [PubMed - indexed for MEDLINE] 7: Keane JR. Alternating skew deviation: 47 patients.Neurology. 1985 May;35(5):725-8. PMID: 3990972 [PubMed - indexed for MEDLINE] 8: Keane JR. Ocular skew deviation. Analysis of 100 cases.Arch Neurol. 1975 Mar;32(3):185-90. PMID: 1119961 [PubMed - indexed for MEDLINE] 9: Mennel S, Hergan K, Peter S. Skew deviation: a precursor to basilar artery thrombosis.Clin Experiment Ophthalmol. 2005 Oct;33(5):536-8. PMID: 16181287 [PubMed - indexed for MEDLINE] 10: Mossman S, Halmagyi GM. Partial ocular tilt reaction due to unilateral cerebellar lesion.Neurology. 1997 Aug;49(2):491-3. PMID: 9270583 [PubMed - indexed for MEDLINE] 11: PARKS MM. Isolated cyclovertical muscle palsy.AMA Arch Ophthalmol. 1958 Dec;60(6):1027-35. No abstract available. PMID: 13593934 [PubMed - OLDMEDLINE for Pre1966] 12: Rabinovitch HE, Sharpe JA, Sylvester TO. The ocular tilt reaction. A paroxysmal dyskinesia associated with ellipticalnystagmus.Arch Ophthalmol. 1977 Aug;95(8):1395-8. PMID: 889516 [PubMed - indexed for MEDLINE] 13: Siatkowski RM, Sanke RF, Farris BK. Surgical management of skew deviation.J Neuroophthalmol. 2003 Jun;23(2):136-41. PMID: 12782926 [PubMed - indexed for MEDLINE]
Language eng
ARK ark:/87278/s6445p43
Format Creation Created in Microsoft PowerPoint
Setname ehsl_novel_dent
Date Created 2009-05-13
Date Modified 2021-05-06
ID 177174
Reference URL
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