Condition Guide

Blepharospasm

Spasm of the Eyelid Muscles

Essential blepharospasm is a debilitating disorder of progressive involuntary spasms of the eyelid muscles. Other muscles in the face or neck may be involved as well. Terms that sometimes are used in the description of this problem include dystonia (impaired or disordered muscle tone) and dyskinesia (a defect in voluntary movement). The onset of blepharospasm is typically in the fifth to sixth decade and is more common in women than in men. Although the cause of essential blepharospasm is incompletely understood, it is thought to be a result of “miscommunication” in the area(s) of the brain responsible for control of the involved muscles.

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Signs & Symptoms

How Blepharospasm Presents

Increased Blinking

Onset is usually heralded by an increase in blinking or squinting.

Forceful Closure

Progresses toward repetitive forceful closure and difficulty opening the eyelids.

Functional Blindness

May result despite an otherwise normal visual system; worsened by stress, fatigue, bright lights, TV, driving and social interactions.

Treatment

Managing Blepharospasm

Systemic Medications

Systemic medications have limited efficacy in treating the disease. However, some patients do benefit from such therapy alone or in conjunction with other treatment modalities.

Botulinum Toxin Injections

Local injection of a medication called botulinum toxin (brand name: Oculinum, Allergan Pharmaceuticals) last two to three months, after which time the injections need to be repeated for continued relief. As with any medication, “Oculinum” has side effects; fortunately, these typically are mild and temporary.

Treating Dry Eye

Dry eyes, in particular, may be the cause of eyelid spasm or can aggravate coexisting essential blepharospasm. Treatment of dry eye or other ocular conditions may reduce eyelid spasm to a level that the patient can tolerate without the need for additional medications or injections.

Related Condition

Hemifacial Spasm

A related disorder involving involuntary spasms of muscles on only one side of the face.

This problem usually is caused by abnormal stimulation of the facial nerve, which travels from the brain to the facial muscles. Hemifacial spasm responds satisfactorily to botulinum toxin injections in most patients.

Concerned About Eyelid Spasms?

Schedule an evaluation to discuss diagnosis and treatment options, including botulinum toxin therapy.

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