From the Guidelines
Excessive blinking in children is most commonly caused by eye irritation, dry eyes, or allergies, which can be triggered by various factors, including increased screen time, and should be evaluated by a pediatrician or eye specialist if persistent or accompanied by other symptoms. Several factors can contribute to excessive blinking in children, including:
- Dry eyes, which can be associated with systemic conditions such as Sjögren's syndrome, lymphoma, or hepatitis C 1
- Allergies, which can cause eye irritation and increased blinking
- Foreign particles in the eye, which can trigger blinking as the body attempts to remove the irritant
- Tics, which are involuntary repetitive movements that can manifest as excessive blinking, particularly in conditions like Tourette syndrome or transient tic disorder
- Eye infections, such as conjunctivitis (pink eye), which can cause blinking along with redness and discharge
- Vision problems, including nearsightedness or astigmatism, which can lead to increased blinking as children strain to see clearly
- Stress, anxiety, or habit, which can also contribute to this behavior
- Increased screen time, which can reduce blink rate and exacerbate dry eye and ocular surface disease in children 1 It is essential to consult a pediatrician or eye specialist if the child's excessive blinking persists for more than a few days, is accompanied by eye pain, redness, or vision changes, or interferes with daily activities. Treatment depends on the underlying cause and may include artificial tears for dry eyes, antihistamines for allergies, antibiotics for infections, or behavioral techniques for tic-related blinking. According to the pediatric eye evaluations preferred practice pattern, children with certain medical conditions or a family history of eye disease are at higher risk for developing eye problems and should be referred for a comprehensive eye examination 1.
From the Research
Causes of Excessive Blinking in Children
Excessive blinking in children can be caused by a variety of factors, including:
- Anterior segment and/or lid abnormalities 2
- Habit tics 2, 3
- Uncorrected refractive errors 2
- Intermittent exotropia 2
- Psychogenic blepharospasm 2
- Dry eye and posterior blepharitis 4
- Tic disorders, such as transient tic disorders, chronic tic disorders, and Tourette's syndrome 3
Characteristics of Excessive Blinking in Children
Studies have shown that:
- The majority of children with excessive blinking present with bilateral symptoms 2
- Boys are more likely to experience excessive blinking than girls, with a ratio of almost 2:1 2
- Most cases of excessive blinking in children are caused by benign and/or self-limiting conditions 2, 5, 6
- Excessive blinking can resolve spontaneously in many cases 5, 6
Diagnosis and Treatment
Diagnosis of the underlying cause of excessive blinking in children is crucial for effective treatment. A careful history and clinical examination can help determine the cause of excessive blinking in most cases 2. In some cases, psychiatric consultation may be necessary, particularly for children with long-standing and frequent eye blinking 3. Treatment for excessive blinking in children depends on the underlying cause, and may include correction of refractive errors, treatment of dry eye and blepharitis, or psychiatric medication for tic disorders 2, 3, 4