I had a interesting case this week. A over 60's patient came in for a general eye exam. Her vision and general eye health were all good however she had a history of eye surgery 10 years prior. During her eye exam whilst sitting in the testing chair I noted her head was tilted. When questioned about the tilt the patient replied puzzled that her head was not tilted- she looked in the mirror and noticed to her surprise- her head was indeed tilted. Time to investigate.
I adjusted the angle of her head to the correct position and yes.... problem found. Double Vision. All the letters in front of her were now doubled. Interestingly she had subconsciously learned to adapt her positioning to counteract her double vision. Often times this would be picked up sooner by family members, doctors or even osteopath as neck and muscular pain can occur.