Children with frequent blinking often visit the ophthalmology department, and many are diagnosed with conjunctivitis and given antibiotic eye drops, or treated with repeated stone extraction because of conjunctival stones. Misdiagnosis of blinking in children not only delays the treatment of the child’s disease, but can also cause drug-related ocular surface damage due to blind use of large amounts of eye drops, or cause conjunctival scar formation due to repeated extraction of conjunctival stones, leading to the formation of medically induced dry eye. How can we properly recognize blinking in children? The following are several common causes of blinking in children: a. Inverted eyelids The eyelids are turned inward and the eyelashes are turned back toward the cornea, creating mechanical stimulation of the cornea, a foreign body sensation that can cause children to blink more frequently. Many children have a history of chalazion and blockage of the lid gland opening. Due to the lack of normal oil secretion, these children show rapid evaporation of the tear film, deposition of lipid debris on the corneal surface, and reduced tear film rupture time. The child usually presents with recurrent eye redness, ocular foreign body sensation, and during the active phase of the disease, corneal limbal lesions can occur and irritation symptoms cause the child to blink more frequently. Allergic conjunctivitis is one of the most common causes of blinking in children. Itchy, dry eyes and an increased number of blinks are the characteristics of the disease. Many children are prone to the onset of the disease in spring and summer, and the symptoms are relieved in winter and continue to develop the following spring, and the cycle continues. Superficial punctate keratitis Dry eye, eye drops toxic irritation, mechanical irritation, allergies can cause punctate corneal epithelial defects, children can appear red eyes, photophobia, increased blinking. Dry eye syndrome With the increased burden of modern children’s studies and the increased exposure to television, computers and other video terminals, children can suffer from dry eyes due to excessive evaporation of tears, leading to an increase in blinking frequency. There are also some children who suffer from rheumatic diseases such as dry syndrome, systemic lupus erythematosus, and systemic rheumatoid arthritis, which cause a decrease in tear production and result in dry eyes, leading to increased blinking. With the increase in bone marrow transplants for childhood leukemia, many children can develop graft-versus-host disease after transplantation, with ocular manifestations such as dry eyes and even corneal ulcers. Refractive abnormalities Because the child has myopia or farsightedness that is not corrected, visual fatigue can also lead to excessive blinking. By properly correcting the refractive error, the child’s symptoms of increased blinking will ease or even disappear. Tic disorder is a common neuropsychological disorder in children, usually affecting children between the ages of 5 and 10. Tic disorders can be exacerbated by high levels of stress and abnormal home education. The tics mostly involve the facial muscles and can manifest as increased blinking, rapid eye movements, nodding, frowning, etc. If there is no significant relief from the removal of eye triggers that may cause increased blinking frequency, and if there is a combination of facial and other behavioral abnormalities, parents need to take their child to a psychiatric consultation to rule out childhood tics if necessary.