This young woman patient has just walked in to your examining room. She appears as you see in the picture with her face turned to the left but she seems to be looking at you.
1. What might be causing this head posture?
a. Duane syndrome
b. left VI nerve palsy
c. null point nystagmus
d. a tight sternocliedomastoid muscle
e. all of the above



2. What simple test would yield the most results quickly with the least effort on your part?
a. checking visual acuity
b. measuring fusion
c. refraction
d. asking the patient to look to the left
e. checking the intraocular pressure



3. What would be the most likely treatment that would be recommended after the work up is completed?
a. extraocular muscle surgery
b. spectacle correction
c. exercises
d. no treatment is likely to be recommended
e. none of the above
Answers:

1. What might be causing this head posture?
e -- all of the above

2. What simple test would yield the most results quickly with the least effort on your part?
d -- asking the patient to look to the left
3. What would be the most likely treatment that would be recommended after the work up is completed?
a -- extraocular muscle surgery