Tardive Dyskinesia - Eye Symptoms

The symptoms of tardive dyskinesia were first noted in 1957, after U.S. psychiatrists used anti-psychotic or neuroleptic medications for about three years. Because these symptoms usually manifested as facial tics such as involuntary movement of the lips, tongue and jaw, it was originally called bucco-linguo-masticatory syndrome, or "cheek-tongue-chewing."

By 1964 however, it had become clear that these symptoms were the side effect of neuroleptic medications. Moreover, these symptoms were not always confined to the face, as the muscles of the throat involved in swallowing and breathing could be affected, creating a dangerous and even life-threatening condition for the patient.

Because antipsychotic medications operate by blocking the neurotransmitters that send signals from the brain to muscle cells, virtually any voluntary muscle or muscle group can be affected. These movements range from very slight and subtle fluttering movements to violent flailing of the arms and legs.

Tardive Dyskinesia and the Eyes

The effects of tardive dyskinesia on the fine musculature that control the eyes thus contributes to the difficulties that such patients experience in social situations. For example, raising the eyebrows suddenly and repetitively can give an impression of impatience to those around the patient when in fact, he or she has no control over such movements.

Such eye movements may be sudden, jerky, or smooth. Normally, smooth pursuit tracking with the eyes is extremely difficult in the absence of an actual moving object on which to focus. In the 1990s, some studies were performed to determine the connection between smooth pursuit eye movements and tardive dyskinesia; however, the study failed to establish whether the connection was with the disorder, or the mental illness for which the patients had been treated.

Rapid eye blinking is one manifestation of tardive dyskinesia. Because this is a relatively small and subtle movement, it may not necessarily be noted by those surrounding the patient. In some cases, this blinking movement — technically known as blepharospasms — can be severe enough to make the patient legally blind.

Another eye movement is called oculogic crisis. This occurs when the eyes roll about in random directions. This is a more obvious symptom than eye blinking and can cause severe disorientation. Involuntary eye movements and other such small, barely noticeable motions may be most prevalent in the earliest stages of tardive dyskinesia.

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