Functional eyelid pulling in children.

Five children (three girls and two boys, aged 3 1/2 to 9 1/2 years) were referred by their pediatricians for evaluation of intermittent pulling on their eyelids. All the children were free of systemic disease. One child wore spectacles for accommodative esotropia but no child had evidence of an acute ocular disorder. The duration of symptoms before examination ranged from one to 13 months. None of the parents were able to identify temporally related stressful events. Reassurance alone was given to both parents and children; eyelid pulling resolved in all cases within two weeks. In only the youngest patient did eyelid pulling recur and no child developed other symptoms during a follow-up of six to 15 months. Following resolution, parents believed their children pulled on the eyelids to gain attention or because their eyes were initially irritated and they then developed a "bad habit." Children said they did it to "look funny" or because their "eyes were not opening enough."