A 13-year-old boy with an 11 year history of Tourette syndrome and progressively worsening tics, both motor and vocal, was referred to the Department of Ophthalmology, Great Ormond Street Hospital, London, because of visual symptoms and reading problems. He felt his eyes were crossing intermittently, but there was no diplopia and no strabismus. Refraction showed a mild hypermetropic astigmatism. Eye movement studies using electrooculography and simultaneous video recording showed dysmetric reflexive and voluntary saccades and failure of antisaccades, characteristic of disease of frontal lobes and basal ganglia. Visual symptoms resolved after spectacles were prescribed for the astigmatism, but reading difficulties were not benefited. 
COMMENT. Patients with Tourette disease may have an inability to form antisaccades, an abnormality of eye movements reflecting disease of the frontal lobes and basal ganglia.