Blepharospasm

Blepharospasm is a frustrating condition which causes involuntary spasms, twitching, blinking or closure of the eyelids. You may feel like you’re constantly squinting. You may also have pain and tension around your eyes.

In severe cases, a person with blepharospasm may be functionally blind for hours due to the spasms. Consequently, they may have difficulty working, playing sports, driving or socialising.

The symptoms tend to worsen over time and can affect one or both eyes.
Blepharospasm affects women more often than men. It typically develops when you’re in your mid-50s and affects about 5 in every 100,000 people.

Blepharospasm may be misdiagnosed or not diagnosed at all due to its similarity to other conditions.

Correct diagnosis of blepharospasm relies on a physical examination, medical history, and ruling out other possible causes. While there is no particular test for this condition, getting a referral to an eye specialist is the first step to managing the symptoms and improving your quality of life.

Although there is no cure for blepharospasm, there are several treatment options:

Stress management techniques and joining a support group   can be helpful in managing symptoms especially if they tend get worse in times of emotional stress.

Tinted (rose coloured) glasses help some people whose eyes are sensitive to bright light.

Injections that relax affected muscles around the eyes can alleviate the spasms. Dr Parker usually recommends multiple injections given both above and below the eyes. The treatment is briefly painful but quick. It can take a few days to kick in and the effect lasts for up to four months.

Temporary side effects such as dry eyes, drooping eyelids (ptosis), and double vision may occur. People respond differently to muscle-relaxing injections and it can take more than one treatment to arrive at the optimum dose.

Muscle-relaxing oral medications are sometimes used, but their success rate varies. Additionally, drugs that control movement disorders can be useful in controlling blepharospasm.

Surgery is considered if other treatments have failed. A ‘myectomy’ is a procedure that involves the removal of some or all of the eyelid and eyebrow muscles responsible for squinting. It can improve symptoms in up to 80% of people with blepharospasm. However, repeat operations may be necessary in the future.