Ophthalmic manifestations of Gilles de la Tourette syndrome

To present the ophthalmic manifestations of patients with Gilles de la Tourette syndrome (GTS).

Sixteen children (average age 11.5 years), with multiple motor and vocal tics, with a diagnosis of GTS, were included in this study. All underwent a full ophthalmological examination.

All patients except one amblyopic case had best corrected visual acuity of 20/20 in both eyes. Eleven patients (68%) had eye tics; nine had clonic blepharospasm and two had involuntary gaze deviations. Four cooperative children underwent visual field examination with Goldmann perimeter, no visual field defect was detected. Three patients had strabismus (one alternating exotropia and two partially accommodative esotropia). Anterior and posterior segment examinations were within normal limits. The symptoms improved considerably in 82% of the patients with eye tics on treatment with a neuroleptic (pimozide).

Blepharospasm was the most common ophthalmic manifestation of GTS. Ophthalmologists should consider a diagnosis of GTS in the absence of any organic eye pathology that may cause blepharospasm and refer these cases to a child psychiatrist. These children benefit from a treatment with neuroleptics under the supervision of a psychiatrist.