Tang Na, Wang Yunjiao, Jiang Xiaohan, Liu Huan, Li Yan, Qu Jia, Xiang Shengjin
National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China.
Key Laboratory of Traditional Chinese Medicine for Myopia Prevention and Control and Chronic Eye Disease Research, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
Front Psychiatry. 2025 Jun 16;16:1553358. doi: 10.3389/fpsyt.2025.1553358. eCollection 2025.
Abnormal blinking is a common symptom shared by allergic conjunctivitis (AC), dry eye disease (DED), and tic disorders (TD). This study explored clinical manifestations of TD in patients with the chief complaint of abnormal blinking; its goal was to reduce misdiagnosis and missed diagnosis.
In total, 1054 patients with the chief complaint of abnormal blinking completed a questionnaire and underwent comprehensive ophthalmic examinations and mental health assessments. Questionnaire data were compiled for patients with a confirmed diagnosis of TD; their clinical characteristics were analyzed.
Of the 1054 patients presenting with abnormal blinking, 453 (42.98%) were diagnosed with a TD. Among these 453 patients, 253 (55.63%) had provisional tic disorder (PTD). 121 (26.71%) patients initially were misdiagnosed (primarily with AC) or experienced a missed diagnosis; Patients with PTD were more likely to seek ophthalmologic care, whereas those with CTD or TS were more likely to visit a paediatrician (P<0.001). The predominant eye tics were excessive and/or frequent blinking; 438 (96.69%) patients exhibited tics other than eye tics. Among the TD patients, 371 (81.90%) reported ocular symptoms, whereas 336 (74.17%) had comorbid eye diseases including AC and DED. PTD patients with AC had higher incidences of allergic rhinitis and asthma compared with patients displaying CTD and TS (P<0.05).
TD are major causes of abnormal blinking, and PTD is the most common subtype. TD patients with abnormal blinking often have comorbid eye diseases, primarily AC and DED.
异常眨眼是变应性结膜炎（AC）、干眼疾病（DED）和抽动障碍（TD）共有的常见症状。本研究探讨以异常眨眼为主诉的患者中TD的临床表现；其目的是减少误诊和漏诊。
共有1054例以异常眨眼为主诉的患者完成了问卷调查，并接受了全面的眼科检查和心理健康评估。对确诊为TD的患者的问卷数据进行整理；分析其临床特征。
在1054例表现为异常眨眼的患者中，453例（42.98%）被诊断为TD。在这453例患者中，253例（55.63%）患有暂时性抽动障碍（PTD）。121例（26.71%）患者最初被误诊（主要误诊为AC）或漏诊；PTD患者更倾向于寻求眼科治疗，而慢性抽动障碍（CTD）或抽动秽语综合征（TS）患者更倾向于就诊儿科医生（P<0.001）。主要的眼部抽动症状为过度和/或频繁眨眼；438例（96.69%）患者还表现出眼部以外的抽动症状。在TD患者中，371例（81.90%）报告有眼部症状，而336例（74.17%）患有包括AC和DED在内的合并眼部疾病。与CTD和TS患者相比，患有AC的PTD患者患变应性鼻炎和哮喘的发生率更高（P<0.05）。
TD是异常眨眼的主要原因，PTD是最常见的亚型。以异常眨眼为表现的TD患者常合并眼部疾病，主要是AC和DED。
