Dystonia is a movement disorder that induces excessive muscle contractions or spasms. Blepharospasm is a form of dystonia. It’s also known as benign critical blepharospasm, and it’s when the eyelids blink or twitch involuntarily and uncontrollably. Blepharospasm typically develops progressively and worsens over time. Although your eyes are fine, the increasingly frequent and prolonged closing of your eyelids affects your vision, leading to functional blindness in extreme cases.
Causes and Symptoms of Blepharospasm
Blepharospasm usually happens without warning and has no known cause. The symptoms can appear gradually, often as a result of certain factors such as fatigue, stress, excessive caffeine, and/or exposure to bright lights. Increased blinking and eye pain could be the first signs. Frequent eye twitching or blinking becomes more common as the disease progresses, and it can be followed by facial or jaw spasms.
Spasms can decrease or disappear during sleep, as well as during periods of intense focus on a specific task, for some people. Although the spasms can begin in one eye, they usually spread to both. Patients with blepharospasm can also experience symptoms of dry eye in nearly half of the cases. Other disorders such as ptosis, dermatochalasis, and entropion can evolve as the condition progresses.
What is the Treatment for Blepharospasm?
Disrupting the initial causes is the first line of treatment for blepharospasm. When you’re outside, wear UV-protected sunglasses to minimize light exposure. Treatment of the related dry eye syndrome with artificial tears, punctal plugs, and/or tear stimulating medication such as Restasis®, as well as regular washing of the eyelids to minimize blepharitis and inflammation, can also aid.
The injection of botulinum toxin, also known as Botox®, into the muscles of the eyelids is the most common, effective, and least invasive treatment for blepharospasm. The eyelid muscles are relaxed, and spasms are disrupted with these injections. The change is usually only temporary, lasting several months. The injections can be given as often as necessary.
If Botox® injections fail to stabilize your blepharospasm and your vision continues to be affected, a surgical procedure known as a myectomy, which involves the removal of some or all of your eyelid muscles and/or nerves, may be suggested.
Surgical treatment of blepharospasm is successful in 75-85% of patients, according to the National Eye Institute. However, because any surgical procedure carries certain complications, myectomy is prescribed for patients who have severe blepharospasm and have not responded to Botox® or other treatments.