Rectus muscle plication in the treatment of anomalous head position associated with nystagmus

Introduction: Patients with nystagmus and head turn are traditionally treated by recession and resection of the rectus muscles as described by Kestenbaum and Anderson. Methods: We present a case series of patients with nystagmus and anomalous head position (AHP) who underwent plication – only surgery of the horizontal rectus muscles from March 1, 2014, to June 1, 2015. Results: Plication amounts ranged from 5mm to 7.5 mm on the medial rectus and 7–12 mm on the lateral rectus. Average pre-operative horizontal AHP was 22.5° and post-operative AHP 2.5° (paired Student t-test P = 0.034) and only one patient required a second surgery. Discussion: We found AHP can be effectively treated with plication – only surgery.