One of the easiest ways we usually identify whether a child’s head is tilted due to ophthalmic strabismus is to cover one of the child’s eyes with gauze. If the child’s tilted head decreases or disappears after covering, this is a time to be highly alert to compensatory head position caused by congenital strabismus. It is true that a child’s crooked head can also be caused by an eye abnormality. For children with no obvious abnormalities in the neck muscles and a crooked head, oculocutaneous squint should be considered. Oculocerebral tilt is mostly caused by congenital paralysis of the eye muscles. The most common form is paralysis of the superior oblique muscle in one or both eyes. Oculocutaneous squint is a compensatory response by the child to avoid double vision (looking at things with 2 non-overlapping shadows) due to impaired movement of the eye muscles in certain directions. The diplopia disappears when the child’s head adopts a particular position (many times it can exhibit a sloping neck). When a child adopts this head position, it reduces the discomfort caused by strabismus, maintains binocular vision, and protects visual function. However, prolonged head tilting can have many negative consequences for the child. First, it causes facial asymmetry due to the tilted head (squint), which causes one side of the face to be full and the other side to be thin due to the effect of gravity. Secondly, it is the effect on the bones of the neck, causing scoliosis of the cervical spine. Third, it may also cause developmental deformities of the mandible. Although the visual function of children with congenital oblique palsy can be protected by compensatory head position (tilted head, sloping neck, etc.). However, this protection is only temporary in many cases. If the abnormalities of the eye muscles do not improve in the long term, this may result in what is called “uncommon diffusion of eye movements”, which may involve more eye muscles. At this point, the head tilt may be reduced, but the protection of visual function is also lost at the same time. This often results in the suppression of one eye to avoid diplopia, with the result that amblyopia develops in the suppressed eye. The child will lose stereo visual function for life. For all these reasons, strabismus caused by congenital oculomotor palsy should be treated early. However, congenital ophthalmoplegia is a complex ocular anomaly that requires an experienced ophthalmologist to make a correct diagnosis. Often, special equipment (e.g., an emmetropic machine) and special examinations (e.g., reanimation examinations) are required to make the diagnosis. However, due to the special nature of the young age of children, it is very difficult to examine and treat children under the age of 3. The synoptic machine, which is usually used for adults or older children, is completely useless for these children. Some congenital ophthalmoplegia is combined with congenital internal strabismus in addition to strabismus, and the examination and treatment of this condition is even more complicated. Even ophthalmologists can do nothing for these children without the use of equipment specifically designed for children. The diagnosis is finally confirmed only after the doctor has examined and examined the child using equipment specifically designed for pediatric ophthalmology. After the diagnosis was confirmed, the child quickly returned to normal through early surgery. In this way, damage to visual function due to delayed treatment is prevented. With surgery, the crooked head phenomenon is treated and the resulting problems such as scoliosis slowly disappear. Doctors have received good results in correcting ocular strabismus caused by strabismus in children using a combination of strabismus correction surgery, wearing a trigeminal lens to correct residual strabismus, and wearing a neck brace to correct neck abnormalities after surgery.