Topics on this page include:

What is blepharospasm? | Symptoms | Causes | Treatment

What is blepharospasm?

Blepharospasm is a common term for the medical conditions benign essential blepharospasm and essential blepharospasm. This problem affects the nerve that controls the muscles around the eye. Characterized by involuntary, tight closing of the eyelids, it can affect one or both eyes. Sometimes other muscles in the face will also twitch, especially those around the cheek and brow. In severe cases, the eyelids are tightly closed for a brief period of time disrupting the person's ability to see. Blepharospasm usually appears around age fifty to sixty and is found in three times as many women as men.

Symptoms

Symptoms for blepharospasm include occasional uncontrolled winking, blinking, or squinting of one or both eyes. Patients experience increased difficulty in keeping their eyes open. They may also experience light sensitivity. As the condition progresses, the eyelid spasms occur more frequently and with greater severity until they are constant. Eventually, both eyelids remain clamped shut and the eyebrows are pulled down.

If you are experiencing some of the symptoms described here, it does not necessarily mean you have blepharospasm. However, if you experience one or more of these symptoms, you should contact your eye doctor for a complete exam. Click here for information on emergency or immediate care.

Causes

Blepharospasm is caused by abnormal nerve impulses to the eyelid muscles. Scientists are not sure why it occurs, but the area of the brain known as the basal ganglia may be involved.

Treatment

A variety of treatments have been used for blepharospasm. A neurological approach including prescription medications or biofeedback training is sometimes used in mild cases.

Sometimes physicians use a surgical approach. This produces limited results, and in some cases, the procedure must be repeated. The myectomy procedure involves resecting and removing muscles in the upper eyelids and brow. The neurectomy procedure, which is rarely performed, involves resectioning and removing small facial branches of the orbicularis muscles.

The treatment of choice, which generally provides good results, is the use of botulin toxin (Botox) injections. The same bacteria that cause botulism when consumed in large amounts produce the botulin toxin. Injecting small amounts of botulin toxin into the eyelids is safe and can stop spasms for several months. However, the results are temporary and the injections must be repeated periodically. Possible side effects, which wear off with time, include drooping eyelids, double vision, and dryness of the eyes.