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Functional eyelid pulling in children
R A Catalano1, M G Trevisani, J W Simon
1Department of Ophthalmology, Albany Medical College, New York 12208.
Insights
Pediatric eyelid pulling in children often resolves with simple reassurance. This behavioral symptom, common in young patients, typically does not indicate underlying ocular disease and rarely recurs.
Area of Science:
- Ophthalmology
- Pediatric Behavioral Health
- Oculoplastics
Background:
- Intermittent eyelid pulling is a behavioral symptom observed in pediatric patients.
- Previous literature lacks comprehensive data on the etiology and management of this specific behavior.
- Understanding the underlying causes and effective interventions is crucial for pediatricians and ophthalmologists.
Purpose of the Study:
- To investigate the clinical presentation and outcomes of children referred for eyelid pulling.
- To evaluate the efficacy of reassurance as a primary treatment modality.
- To identify potential triggers and long-term prognosis of this pediatric ocular behavior.
Main Methods:
- Retrospective case series of five children (3.5–9.5 years old) evaluated for intermittent eyelid pulling.
- Clinical history, duration of symptoms, and parental/child reports were documented.
- Treatment consisted of reassurance alone, with follow-up ranging from six to 15 months.
Main Results:
- All five children experienced complete resolution of eyelid pulling within two weeks of reassurance.
- No child exhibited signs of acute ocular disorders or systemic disease.
- Recurrence was noted in only one patient; no new symptoms developed during follow-up.
Conclusions:
- Eyelid pulling in children is often a benign behavioral issue that responds well to simple reassurance.
- The behavior may be linked to attention-seeking, perceived eye irritation, or a desire to 'look funny'.
- This condition typically has a favorable prognosis with no significant long-term ocular or systemic sequelae.
Abstract:
Five children (three girls and two boys, aged 3 1/2 to 9 1/2 years) were referred by their pediatricians for evaluation of intermittent pulling on their eyelids. All the children were free of systemic disease. One child wore spectacles for accommodative esotropia but no child had evidence of an acute ocular disorder. The duration of symptoms before examination ranged from one to 13 months. None of the parents were able to identify temporally related stressful events. Reassurance alone was given to both parents and children; eyelid pulling resolved in all cases within two weeks. In only the youngest patient did eyelid pulling recur and no child developed other symptoms during a follow-up of six to 15 months. Following resolution, parents believed their children pulled on the eyelids to gain attention or because their eyes were initially irritated and they then developed a "bad habit." Children said they did it to "look funny" or because their "eyes were not opening enough."