Eye tics and twitches in children

What are tics?

As explained in the topic written about tics in general, tics are involuntary, sudden and rapid movements of a muscle or specific organ in our body.
Tics can be motoric (i.e the movement of a muscle in the body) or vocal (i.e the making of a sound such as a cough, clearing the throat or any other sound).
Motoric tics are short, sudden and repetitive movements and they seem to be involuntary. Motoric tics involve only a group of muscles or a single part of the body (for example, the face, neck, shoulders or hands).
The first most common motoric tics are the ones in the eye and mouth area, while the second most common are ones in the neck, shoulder and imbs.

What are the most common eye tic signs in children?

The most common eye tics in children including excessive blinking, usually of both eyes, upward eye rolling or wide opening of the eyes. Watch the video attached here of cute little Itamar.

Do eye tics or twitches need to be examined by a pediatrician and then an ophthalmologist?

When any type of tic first appears, do not stress over it, but see your pediatrician for a consult as soon as possible.The pediatrician will take a full history from the parents, will examine the child and will decide together with the parents whether there is an organic cause for the symptoms or findings and whether further investigation is required.

When should an ophthalmologist be seen?

When eye tics first appear, or if their pattern changes, we like to make sure that the cause is truly tic movements and not a different disorder that is causing these involuntary movements. It is important to keep in mind that some movements may seem similar to tics but may actually be caused by a foreign object under the eyelid or in the cornea, dryness of the eye or a severe allergic reaction with findings in the eyelids that disturb the child and cause a strong twitch. In addition, a refractive error must be ruled out (i.e the need for prescription lenses) since abnormal vision can also cause contraction of the eyes.
If there are any findings in the eyes, the treatment is tailored to the cause, and the movements will resolve. However, there is no pharmacological or optic treatment for movements that are truly caused by a tic disorder, and this tends to simply resolve with time, without any specific intervention.
If there is evidence of a complex tic disorder where more than one muscle group is involved, or vocal tics are involved, then a pediatric neurologist who specializes in the field should be consulted.

In summary, eye tics are a common topic in pediatrics that may cause distress to many parents. As mentioned above, sometimes a short investigation is required, but most cases are considered benign as they resolve spontaneously, hopefully in a short period of time.