A case review is presented to understand the clinical implications for children presenting to ophthalmology with episodes of excessive blinking in the absence of any obvious ocular abnormalities. This retrospective review was conducted from 2011-2014. The authors contacted parents and were able to conduct telephone interviews with 34 parents of 34 children with mean age of 4.48 years. Associated symptoms were eye rolling, itching, burning, rubbing, eyelid squeezing and pulling, and facial grimacing. Duration of symptoms prior to presentation was three days to nine months. Visual acuity ranged from 20/20 to 20/40. There was no ocular pathology in 91%. One child had mild blepharitis, one with allergic conjunctivitis and one myope. Seven cases had a specific cause including two with allergies, one needing glasses, two with ADHD and two with Tourette syndrome; 71% had complete resolution, six improved and four had no improvements. The authors recommend all children with excessive blinking undergo a complete eye examination. Episodes are rarely indicative of neurological disease and frequently resolve spontaneously. 

Episodic excessive blinking in children.
Mali YP, Simon JW, Chaudhri I, et al.
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Fiona Rowe (Prof)

Institute of Population Health, University of Liverpool, UK.

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