Excessive blinking 'not cause to worry'

SAN FRANCISCO — Although excessive blinking may be caused by a large number of potential problems, in most cases the causes are benign, and serious conditions can usually be detected with clinical examination, according to a study in Ophthalmology.

Ninety-nine children under the age of 16 with excessive blinking underwent a detailed history and ophthalmic examination. In the 89 patients who reported bilateral blinking, the most common causes were habit tics, undiagnosed refractive errors, conjunctivitis, mental or emotional causes and intermittent exotropia.

Of the 10 patients with unilateral blinking, the most common causes were habit tics, Marcus-Gunn jaw winking syndrome — a congenital defect in which a droopy eyelid opens widely while chewing, sucking or moving the mouth to the opposite side of the body — and sporadic twitching of part of the eyelid muscle caused by fatigue. Six of the 99 patients were diagnosed with vision-threatening conditions, but in all cases the problem was easily detected on clinical examination.

"This study offers a blueprint for caring for children with excessive blinking," said David. K. Coats, MD, first author of the study and an assistant professor of ophthalmology and pediatrics at the Baylor College of Medicine and chief of ophthalmology at Texas Children's Hospital in Houston. "We hope physicians will be able to tailor their examinations to the needs of the patient and that identification of a specific and treatable condition may be more likely to occur."

The study was supported in part by an unrestricted grant from Research to Prevent Blindness.