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Eye Care Archive (Expert Forum)
8yr old, periodic outward rolling eyes, excessive blinking and nasal twitching
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8yr old, periodic outward rolling eyes, excessive blinking and nasal twitching
by malta, Aug 11, 2006 12:00AM
8 months ago, my daughter started periodically having excessive blinking, we hoped it was transient and didn't bring attention to it too much. When we noticed it became accompanied by an outward rolling of her eyes her pediatrician recommended a Ped Opthalmologist. The blinking lessened over the 6weeks before the Opthal. appointment, but the eye "rolling" continued intermittently, especially in the evenings. The Ped. Opthal didn't seem concerned and said to come back in a few months if it didn't go away.However the Dr. didn't see my daughters eyes rolling at the visit.Now my daughter has started twitching her nasal area as if she has an itch and it seems her lips are slightly doing it too. The blinking seems to have gone but her eyes roll together to the right generally.What could this be? I am going to take her to a different Ped Opthalmologist in a few weeks. Do I need to take her to a Ped Neurolosist? FYI, she is a happy kid, no caffine low stress. Thank you
Doctor's Answer
by Forum-OD-MP, Aug 11, 2006 12:00AM
a second opinion is never a bad idea.
this could be anything from totally benign allergy and itchy/dry eyes which she has figured out that she gets some relief from the "rolling"/blinking, to some neurologic disorder (which i personally highly doubt, but cannot rule out altogether)
try this little test:
go to the pharmacy and buy some pediatric allergy medicine like benadryl. even if she doesnt have other allergy symtoms. also buy some over-the-counter allergy eyedrops (naphcon-A, opcon-A, etc). have her take the minimum dose for her age of the oral allergy medicine and instill 1 drop in each eye of the antihistamine eyedrop. they will sting a little.
then watch her for the next say hour or 2. if the blinking/rolling is recuced/eliminated then this is probably ALLERGY (a common cause of excessive blinking in children).
now, here's the caveat: i do not ever recommend more than 10 consecutive days use of any over-the-counter anti-allergy eyedrop. they're generally bad for you to use chronically b/c of the potent vasoconstrictors they contain. but if this little "test" works, then ask the pediatic ophthalmologist or your optometrist for a prescription antihistamine eyedrop (like optivar or patanol) that you could safely use on your daughter chronically.
most (all?) neurologic disorders that involve eye movements have the following qualities:
1) happens all the time, not just periodically
2) involve "jerking" from side to side, not usually "rolling"
3) do not involve blinking
so the fact that you say this is "periodic", not CONSTANT, and there is no horizontal or vertical "jerking" of the eyes, and her vision/eye health seemed to be normal when the 1st doc checked...all of that leads me to believe this is probably NOT any serious neurological disorder.
this could be anything from totally benign allergy and itchy/dry eyes which she has figured out that she gets some relief from the "rolling"/blinking, to some neurologic disorder (which i personally highly doubt, but cannot rule out altogether)
try this little test:
go to the pharmacy and buy some pediatric allergy medicine like benadryl. even if she doesnt have other allergy symtoms. also buy some over-the-counter allergy eyedrops (naphcon-A, opcon-A, etc). have her take the minimum dose for her age of the oral allergy medicine and instill 1 drop in each eye of the antihistamine eyedrop. they will sting a little.
then watch her for the next say hour or 2. if the blinking/rolling is recuced/eliminated then this is probably ALLERGY (a common cause of excessive blinking in children).
now, here's the caveat: i do not ever recommend more than 10 consecutive days use of any over-the-counter anti-allergy eyedrop. they're generally bad for you to use chronically b/c of the potent vasoconstrictors they contain. but if this little "test" works, then ask the pediatic ophthalmologist or your optometrist for a prescription antihistamine eyedrop (like optivar or patanol) that you could safely use on your daughter chronically.
most (all?) neurologic disorders that involve eye movements have the following qualities:
1) happens all the time, not just periodically
2) involve "jerking" from side to side, not usually "rolling"
3) do not involve blinking
so the fact that you say this is "periodic", not CONSTANT, and there is no horizontal or vertical "jerking" of the eyes, and her vision/eye health seemed to be normal when the 1st doc checked...all of that leads me to believe this is probably NOT any serious neurological disorder.
We just tried the Benadryl allergy medicine and Visine allergy eyedrops. After 2 days of this, there has been no change.
My daughter is very apprehensive about going to a doctor again. We brought her to an optometrist when we first noticed the symptoms. He said everything was fine.
But 2 months later, I don't see any improvement. I think it's getting worse. My daughter doesn't think it's a big deal, and says she's fine.
You've mentioned it could be a neurological disorder. Is there any other symptoms to look for?
This may be a strange question, but could the use of lice treatment cause neurological problems? Just over a year ago, we had a terrible challenge controlling a lice infestation problem. We tried 3 different kinds of lice shampoo's. I'm afraid I can't recall the product names at the moment, but I just want to know if there could be any correlation. I've heard horror stories about certain lice treatment.
IT WORKS! The injections are covered by medical health insurance. You definately want to bring your child to an established eye hospital or competant neurologist who is experienced in this therapy. When i moved and wanted to continue treatment, I called many Drs offices to see if this was a tretment they were familiar with and practiced before i booked an appt. After I received injections (yes it hurts for a few moments) several days later my blinking would be normal for up tp 6 months.
Once school starts it seems to appear again. I've come up with a 100 reasons why he does it, dry in the school, nervousness, or just a habit. I've had friends tell me it's because he's tired, well he wakes up doing it, so I ruled that out! After reading your post, I'm hoping too it's allergies! He was on Zyrtec for 2 years, but last year didn't seem to need it. Like you said, this year is a different story. I watch him constantly and lately it's been non-stop. He tightly closes his eyes shut more than just the normal blinking.
I too want to take him to a pediatic doctor and have a thorough exam. I'm guessing with your son that the Zyrtec may not be strong enough since he's been on it so long. I know we had to try a couple different medicines before the Zyrtec, but that really did the trick for us. Best of luck to you and I hope we can get to the bottom of this!