Excessive blinking is common in children. Causes include corneal and eyelid abnormalities, stress reactions, and tics. Ocular tics are usually benign and self-limited. Neurologic consultation may be indicated for patients with multiple tics to evaluate for Tourette syndrome. Hemifacial spasm causes unilateral forceful blinking and facial muscle contraction. Imaging is indicated in hemifacial spasm because the disorder may be caused by central nervous system lesions. See BCSC Section 7, Oculofacial Plastic and Orbital Surgery, for additional discussion of hemifacial spasm. Squinting may occur in patients with strabismus or uncorrected refractive errors.
Figure 17-13 Trichotillomania. Note the segmental loss and irregular lengths of the eyelashes.
(Reproduced with permission from Lueder GT. Pediatric Practice Ophthalmology. New York: McGraw-Hill Professional; 2010;155.)
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.