Excessive Blinking in Children

Parents often wonder if they should worry about their child’s excessive blinking. While this symptom is not typically worrisome, it’s important to see your pediatrician or ophthalmologist if your child blinks a lot or has other concerning symptoms. Rarely, excessive blinking can be a sign of a neurological problem or lead to loss of vision.

What Causes Excessive Blinking in Children?

A large study of children younger than 16 showed four common causes of excessive blinking:

• Problems with the cornea at the front of the eye. These include dry eye, ingrown eyelash, a foreign object in the eye or under the eyelid, corneal abrasion (scratch or scrape at front of eye), eye allergies, or conjunctivitis (pink eye).
• Habitual tics (involuntary repetitive body movements). A common tic is blinking. Tics are usually caused by stress/anxiety, fatigue or boredom. In most cases, tics are harmless, and children outgrow them.
• Uncorrected refractive errors. The need for glasses or an updated glasses prescription to correct nearsightedness (myopia), farsightedness (hyperopia), or astigmatism.
• Misaligned or crossed eyes (strabismus). Strabismus is when the eyes are not lined up correctly, pointing in different directions.

Sometimes, no obvious cause is found to explain excessive blinking. Have your child reevaluated if the blinking persists.

How Is Excessive Blinking Diagnosed?

Your ophthalmologist can find out what’s causing your child’s excessive blinking during an exam. They will:

• Examine the front of the eye. Your doctor uses a special microscope with a bright light (called a slit lamp) to see if your child has any problems affecting the cornea at the front of the eye.
• Check eye alignment. Crossed eyes (strabismus) sounds easy to diagnose, but some children’s eyes don’t cross visibly to parents, or cross intermittently (not all the time). When strabismus isn’t obvious, a pediatric ophthalmologist uses different tests to examine the movement of the eyes and see how well they work together.
• Check visual acuity (sharpness). This includes reading the eye chart to see if your child needs glasses.

How Is Excessive Blinking Treated?

Treatment for excessive blinking depends on what’s causing it:

• Ingrown eyelash/foreign object. The eyelash or other irritant is removed from the eye.
• Allergies, conjunctivitis or dry eye. Your doctor may recommend over-the-counter or prescription eye drops or other treatments.
• Corneal abrasion. Your child may need to wear a patch. This reduces blinking and helps the scratch heal. Moisturizing or antibiotic eye drops/ointment may also be used.
• Refractive error. Glasses are prescribed when excessive blinking is caused by a refractive error like nearsightedness (myopia).
• Strabismus. Sometimes glasses alone can straighten a child’s eyes. Other children need eye exercises or eye muscle surgery to align the eyes.
• Habit tic. Excessive blinking from a tic usually doesn’t need treatment. Tics can take months to go away. Talk with your pediatrician to find what triggers your child’s tic. Tics are made worse by stress, fatigue, anxiety or as a side effect of ADHD medications.

If your child has other tic symptoms (like vocal tics, which include coughing or throat clearing), your doctor may refer you to a neurologist. This can be a sign of Tourette’s syndrome.

If no cause is found, and there are no other symptoms, observation is usually all that is needed. If you see any new symptoms, see your ophthalmologist for a follow-up exam.