Ophthalmic manifestations of Gilles de la Tourette syndrome

PURPOSE. To present the ophthalmic manifestations of patients with Gilles d e la Tourette syndrome (GTS). METHODS. Sixteen children (average age 11.5 years), with multiple motor and vocal tics, with a diagnosis of GTS, were included in this study. All unde rwent a full ophthalmological examination. RESULTS. All patients except one amblyopic case had best corrected visual a cuity of 20/20 in both eyes. Eleven patients (68%) had eye tics; nine had c lonic blepharospasm and two had involuntary gaze deviations. Four cooperati ve children underwent visual field examination with Goldmann perimeter, no visual field defect was detected. Three patients had strabismus (one altern ating exotropia and two partially accommodative esotropia). Anterior and po sterior segment examinations were within normal limits. The symptoms improv ed considerably in 82% of the patients with eye tics on treatment with a ne uroleptic (pimozide). CONCLUSIONS. Blepharospasm was the most common ophthalmic manifestation of GTS. Ophthalmologists should consider a diagnosis of GTS in the absence of any organic eye pathology that may cause blepharospasm and refer these case s to a child psychiatrist. These children benefit from a treatment with neu roleptics under the supervision of a psychiatrist.