What should I do if my child is blinking all the time?

Frequent blinking in a child or young person often worries their parents/carers. However, frequent blinking is rarely caused by serious underlying conditions. An early consultation with a specialist can provide re-assurance and management options.
 

We decided to speak with Dr Annegret Dahlmann-Noor , a leading ophthalmologist and an expert in eye conditions that affect children, to find out what the causes of excessive blinking are.

In this article, we cover the function of blinking, how to determine when you’re blinking excessively, how you can help your child treat this symptom and when you should take your child to an ophthalmologist.
 

Why do we blink?

Blinking is a natural mechanism to smoothen out the tear film across the cornea, the clear window at the front of the eye. The tear film protects the surface of the eyeball and is the first line of defence against things in the environment which could damage the clarity and transparency of the cornea.

When the eyes are open, the tear film dries up, and little dry patches appear on the cornea. Nerve fibres in the cornea detect this change and trigger a blink, which redistributes the tear film and moistens the cornea. Under normal conditions, we blink around 12 to 15 times per minute.
 

What is considered excessive blinking?

Parents often notice that in addition to the normal blinking pattern, their child may have episodes of very fast blinks, or that they are squeezing their eyelids together. Both would be forms of “excessive blinking”.

What causes children to blink a lot?

There are two main causes for frequent blinking or lid squeezing in children: inflammation on the surface of the eye, and “functional” issues – essentially habits that children may develop. The commonest causes for eye surface inflammation in children are allergic eye disease and blepharitis.

In brief, eye allergies are usually triggered by factors in the environment – the commonest forms are seasonal ( hayfever ) and perennial allergic eye disease (all year round). Rare form occur in children with asthma or eczema (atopic eye disease) or boys mainly from sub-Saharan, Mediterranean or Middle-Eastern family backgrounds (vernal eye disease). Blepharitis is a chronic inflammation of glands inside the eyelids which produce an oily layer that covers the tear film and prevents it from drying up too quickly.

The other main cause for frequent blinking or lid squeezing are “functional” issues, now called “perplexing symptoms”. These are comparable to tummy aches or headaches and can be a stress response. Triggers can be problems at school, with friends, or within the family. A diagnosis of perplexing symptoms is only made after a careful assessment of the child’s vision and eye health.

Lastly, children may also squeeze their eyelids together to see better. This happens when children are becoming short-sighted, but have not yet had a test for glasses.
 

Fortunately, in most cases frequent blinking is not a sign of a serious underlying condition. However, it is important to diagnose allergic eye disease and blepharitis quickly, as uncontrolled inflammation can damage the cornea.

How can I help my child stop blinking?

Self-care measures depend on the cause of the frequent blinking. In allergic eye disease, cold compresses applied to the eyelids can bring some relief. In blepharitis, warm lid compresses and meticulous cleaning of the lid margins once a day will stabilise the tear film. In both conditions, artificial tear eyedrops, which can be purchased from the local chemist or optometrist, can also make the eyes more comfortable.

 

When should I take my child to an ophthalmologist?

Children younger than 6 years should see an ophthalmologist specialising in children’s eye problems. Assessing vision in children under the age of 6 years requires specialist training, which staff in children’s eye clinics have. Assessment of the eye surface and making a diagnosis of allergic eye disease and blepharitis is also best carried out by a specialist.

As a general rule, it is sensible to try self-care measures such as cold or warm lid compresses and artificial tear eyedrops for up to two weeks, but to seek professional advice if there is no improvement in symptoms, i.e. if the frequent blinking does not change.

For more information regarding the treatment of frequent blinking or other eye issues, we recommend getting in touch with a leading ophthalmologist such as Dr Annegret Dahlmann-Noor . Click here to visit her profile today for information on appointment availability and her main areas of expertise.