The NVM Screening Kit

Test 1: The Head Tilt and Gait Analysis

Thank you again for listening to us at the 2023 ALLDocs Annual Meeting! This is your first step in our exclusive Screening Kit, just for ALLDocs members like yourself!
The Head Tilt and Gait Analysis is something you can do quickly with your patient while you're walking them out or at the end of an exam. It's a great way to start understanding some of the lesser seen symptoms of Vertical Heterophoria. In our video here, a patient is performing a Gait analysis.

How to Perform The Head Tilt Analysis

1. Sit directly in front of your patient.

2. Start a conversation with them to keep them relaxed.

3. As you do so, observe their head posture.

How to Prepare to Perform the Gait Analysis

1. Center your patient in the middle of a hallway.

2. Pick a target at the end of the hallway that is eye level with the patient.

3. Tell the patient to walk down the hallway while looking at the target, then to walk back to you.

What to Look for in the Head Tilt Analysis:

1. Observe their overall head position. Is a tilt obvious? Is the line from their nose to their chin 90 degrees with the line shoulder to shoulder?

2. Observe the position of other parts of their head. Is one ear higher than the other? Is the part in their hair on the "higher" side?

What to Look For in the Gait Analysis:

1. Observe their stride. Are their arms stiff or strides short? Do they only move one arm or shuffle?

2. Observe their trajectory. Are they drifting to one side or weaving? Does their head point in the same direction? Do they look unsteady at the turn?

3. Observe their confidence. Are they reaching for the wall? Could they stay upright easily if something changed? Are they taking an extra step at the turn?

Analyze Your Results

If You See a Concerning Head Tilt…

…the patient most likely has a vertical misalignment, but others who treat for headaches, dizziness, anxiety, neck pain and other symptoms don't tend to connect these dots. If you're concerned about the patient, it may be time to ask about other symptoms they may have in order to truly understand if this is a VH problem.

If You See a Gait Abnormality…

…it may just be Vertical Heterophoria. These abnormalities do not always come from acute events, but build up over time for numerous reasons. However, an abnormality in a patient's walk can be an easy sign to consider using microprism to help.

Now that you have an understanding, get out there and use this test. Once you've identified a few patients we'll send the next test, the NeuroVisual Medicine Survey next week!