title: The long-term outcomes of ocular tics in a pediatric neuro-ophthalmology practice.
abstract: OBJECTIVE
  To describe the outcome and comorbidities of ocular tics in children evaluated by a pediatric neuro-ophthalmologist.
  
  
  METHODS
  The medical records of all consecutive patients in a pediatric neuro-ophthalmology practice diagnosed with ocular tics (eye rolling, blinking, and widening) were retrospectively reviewed. Children with known secondary causes for tics were excluded. Patients, parents, and/or guardians were contacted by telephone to obtain follow-up information.
  
  
  RESULTS
  A total of 43 patients were included in the retrospective cohort, with a mean age of 7.8 ± 4.8 years at diagnosis. Thirty-two patients participated in the follow-up survey, with an average follow-up of 6.1 ± 3.9 years. None of the 43 children carried a diagnosis of Tourette syndrome or obsessive-compulsive disorder (OCD) at presentation; 1 child had attention deficit hyperactivity disorder (ADHD). At follow-up, 14 of the 32 children (44%) had persistent ocular tics, 3 (9%) reported new nonocular motor tics, 5 (16%) reported new vocal tics, and 4 (13%) developed both nonocular motor and vocal tics. One patient (3%) was formally diagnosed with Tourette syndrome during the follow-up interval, and 3 (9%) were diagnosed with ADHD.
  
  
  CONCLUSIONS
  Almost half of the children with ocular tics at presentation had persistent ocular tics on follow-up. New nonocular motor and vocal tics occurred in several patients.
authors.affiliation: Scheie Eye Institute, University of Pennsylvania, Philadelphia.
authors.forename: Esther R
authors.initials: ER
authors.lastname: Bisker
authors.affiliation: Department of Ophthalmology and Visual Sciences at Washington University, St. Louis, Missouri.
authors.forename: Collin M
authors.initials: CM
authors.lastname: McClelland
authors.affiliation: Division of Neurology, Children's Hospital of Philadelphia, Philadelphia.
authors.forename: Lawrence W
authors.initials: LW
authors.lastname: Brown
authors.affiliation: Neuro-Ophthalmology Service, Children's Hospital of Philadelphia, Philadelphia; Departments of Neurology and Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Electronic address: liug1@email.chop.edu.
authors.forename: Grant T
authors.initials: GT
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005128:Eye Diseases / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013981:Tic Disorders / Q000175:diagnosis / Q000453:epidemiology*; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology