From Philipp Machler, "We have extended the support for Wacom Tablet devices:

- Mac OS X
  - not only pressure, but tilt and z-rotation is supported now
"

src/osgGA/EventQueue.cpp

@@ -99,6 +99,18 @@ void EventQueue::penPressure(float pressure, double time)
     addEvent(event);
 }
 
+void EventQueue::penOrientation(float tiltX, float tiltY, float rotation, double time)
+{
+    GUIEventAdapter* event = new GUIEventAdapter(*_accumulateEventState);
+    event->setEventType(GUIEventAdapter::PEN_ORIENTATION);
+    event->setPenTiltX(tiltX);
+    event->setPenTiltY(tiltY);
+    event->setPenRotation(rotation);
+    event->setTime(time);
+    
+    addEvent(event);
+}
+
 void EventQueue::penProximity(GUIEventAdapter::TabletPointerType pt, bool isEntering, double time)
 {
     GUIEventAdapter* event = new GUIEventAdapter(*_accumulateEventState);

src/osgGA/GUIEventAdapter.cpp

@@ -39,6 +39,9 @@ GUIEventAdapter::GUIEventAdapter():
     _mx(0.5),
     _my(0.5),
     _pressure(0.0),
+    _tiltX(0.0),
+    _tiltY(0.0),
+    _rotation(0.0),
     _buttonMask(0),
     _modKeyMask(0),
     _scrollingMotion(SCROLL_NONE),
@@ -66,6 +69,9 @@ GUIEventAdapter::GUIEventAdapter(const GUIEventAdapter& rhs,const osg::CopyOp& c
     _mx(rhs._mx),
     _my(rhs._my),
     _pressure(rhs._pressure),
+    _tiltX(rhs._tiltX),
+    _tiltY(rhs._tiltY),
+    _rotation(rhs._rotation),
     _buttonMask(rhs._buttonMask),
     _modKeyMask(rhs._modKeyMask),
     _scrollingMotion(rhs._scrollingMotion),
@@ -100,3 +106,15 @@ void GUIEventAdapter::setInputRange(float Xmin, float Ymin, float Xmax, float Ym
     _Xmax = Xmax;
     _Ymax = Ymax;
 }
+
+const osg::Matrix GUIEventAdapter::getPenOrientation() const
+{
+    float xRad = osg::DegreesToRadians ( getPenTiltY() );
+    float yRad = osg::DegreesToRadians ( getPenTiltX() );
+    float zRad = osg::DegreesToRadians ( getPenRotation() );
+    osg::Matrix xrot = osg::Matrix::rotate ( xRad, osg::Vec3f(1.0f, 0.0f, 0.0f) );
+    osg::Matrix yrot = osg::Matrix::rotate ( yRad, osg::Vec3f(0.0f, 0.0f, 1.0f) );
+    osg::Matrix zrot = osg::Matrix::rotate ( zRad, osg::Vec3f(0.0f, 1.0f, 0.0f) );
+    
+    return ( zrot * yrot * xrot );
+}

src/osgViewer/GraphicsWindowCarbon.cpp

@@ -864,6 +864,20 @@ bool GraphicsWindowCarbon::handleMouseEvent(EventRef theEvent)
             getEventQueue()->penProximity(pointerType, (theTabletRecord.enterProximity != 0));
         }
 
+        // get tilt and rotation from the pen
+        TabletPointRec theTabletPointRecord;
+        if(noErr == GetEventParameter(theEvent,  kEventParamTabletPointRec, typeTabletPointRec, NULL, 
+                sizeof(TabletPointRec), NULL, (void *)&theTabletPointRecord)) 
+        {
+            int penRotation = (int)theTabletPointRecord.rotation * 9 / 575; //to get angle between 0 to 360 grad
+            penRotation = -(((penRotation + 180) % 360) - 180) ;          //for same range on all plattforms we need -180 to 180
+            getEventQueue()->penOrientation (
+                    theTabletPointRecord.tiltX * 60 / 32767.0f,  //multiply with 60 to get angle between -60 to 60 grad
+                    -theTabletPointRecord.tiltY * 60 / 32767.0f,  //multiply with 60 to get angle between -60 to 60 grad
+                    penRotation
+            );
+        }
+            
         switch(GetEventKind(theEvent))
         {
             case kEventMouseDown: