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This 6-year-old boy has Down’s syndrome.  He was given glasses by an optometrist, who said that the child can see well, but the family is concerned that the boy habitually raises his chin while looking straight ahead.

1.	What is the most likely reason that this boy would assume the head posture of chin up and look down?
	a. habit b. This is the usual head posture for patients with Down's syndrome. c. tight neck muscles d.  He can see better. e. none of the above
2.	As you approach this child and simply observe him, what would you be looking for first?
	a. anisocoria b. blepharitis c. nystagmus d.  lid fissure abnormalities e. tightness of the neck muscles
3.	If this boy could be helped to assume a more normal head posture while enjoying best vision what would be the likely treatment?
	a. eye muscle surgery b. prism c. orthopedic surgery d.  Botox e. none of the above

For answers to the above, click here on or after February 19, 2008.