A Child With Involuntary and Intermittent Eyelid Movements

Ahmar Sajjad, MD; Kimberly G. Yen, MD


October 21, 2016

A 2-year-old boy presented to the pediatric ophthalmology clinic because his left eyelid was moving up and down intermittently. His mother stated that she had seen this movement occur since birth, mostly when the child moved his mouth. She felt that the eyelid movement had not changed since birth. The eyelid was not constantly droopy, the child seemed to see well, and he did not use any head position to see. His mother had not noticed any ocular misalignment and felt that the child could see well.

On examination, the child had mild ptosis. He was able to fix and follow with each eye separately without preference. He was orthophoric, and motility was full. Findings on pen light examination and fundus examination were normal, and he had no significant refractive error.

External examination demonstrated an up-and-down movement of the left eyelid when the child was told to chew (Figure 1; Figure 2; Video).

Figure 1. Photograph of the patient showing mild ptosis.

Figure 2. Photograph showing the patient's intermittent eyelid position during chewing.

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Video. Demonstration of the patient's involuntary and intermittent eyelid movements during chewing.


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