Background: Tourette syndrome is a stress-sensitive neurologic disorder characterized by involuntary vocal and motor tics. Both Tourette syndrome and the medical treatment for this condition can affect the eye.
Case reports: Case 1: A 5-year-old boy was brought in to see the optometrist by his mother for excessive "flinching" of the eyes. The flinching was actually excessive blinking and, after consulting with the patient's pediatrician and a neurologist, Tourette syndrome was diagnosed. Case 2: An adult male patient complained that, on occasion, he would forcibly blink out his soft contact lenses. He had previously received a diagnosis of Tourette syndrome, which is successfully managed with medication.
Conclusion: Eye signs in Tourette syndrome include excessive blinking, squinting, eye rolling, exaggerated eye opening and closing, and problems with saccades. Because the eye can be involved in Tourette syndrome, the optometrist should be aware of the different manifestations of the condition, which often go unrecognized.