Blepharospasm is the involuntary contraction of the eyelids. There are two types of blepharospasm:
- Benign Essential Blepharospasm
- Secondary Blepharospasm
The cause of essential blepharospasm is unknown. It is often bilateral, but sometimes it may start on one side and later spread to both sides. It is more commonly observed in individuals between the ages of 40 and 60, and it is more frequent in women.
Secondary Blepharospasm, on the other hand, is usually unilateral and is associated with other medical conditions. Causes of Secondary Blepharospasm include dry eyes, eyelid inflammation (Blepharitis), foreign bodies in the eye, trauma, and certain neurological disorders.
What kind of complaints does essential blepharospasm cause?
- Eyelid twitching
- Twitching can occur in both eyelids or sometimes only in the upper eyelid.
- Twitching is involuntary, but situations such as light, loud noises, fear, and stress can trigger or increase the frequency of twitching.
- The frequency and intensity of twitching can vary. Sometimes it can be severe enough to obstruct vision.
What are the causes and risk factors of essential blepharospasm?
The exact cause of essential blepharospasm is unknown, but stress, certain neurological medications used in Parkinson’s disease, high light levels, and loud noises can increase the duration and frequency of spasms.
How is essential blepharospasm diagnosed?
The diagnosis is usually made through clinical examination. The most important aspect is to rule out (exclude) the causes of secondary blepharospasm.
Treatment options for essential blepharospasm can be broadly categorized into two main approaches:
- Medical Treatment: The primary medication used in the medical treatment of essential blepharospasm is botulinum toxin, commonly known as botox. Botulinum toxin injections are administered to the muscles responsible for the spasms. Typically, within 3 days of receiving botox injections, the spasms start to subside, and they usually cease completely within a week. The duration of the effect of Botox varies, typically lasting between 3 to 4 months. When the spasms reoccur, additional injections are needed.
- Surgical Treatment: Surgical treatment for essential blepharospasm involves two main approaches:
- Myectomy: This involves the surgical removal of the muscles that are causing involuntary movements. By eliminating the problematic muscles, the spasms can be controlled or reduced.
- Neurectomy: This surgical procedure targets the nerves responsible for triggering muscle contractions. By damaging or disabling these nerves, the spasms can be alleviated.
These treatment options are aimed at relieving the symptoms of essential blepharospasm by addressing the underlying muscle and nerve abnormalities that lead to involuntary eyelid spasms. The choice of treatment method may depend on the severity of the condition and the patient’s response to previous treatments. Patients should consult with a healthcare professional to determine the most suitable treatment plan for their specific case.
Will i experience problems after botox?
Yes, sometimes unexpected problems can occur after botox injections. These issues are often due to either incorrect Botox applications or patients not following the doctor’s post-treatment instructions. These problems can include:
- Drooping eyelids
- Lower eyelid pulling
- Watery eyes
- Light sensitivity
- Double vision
- Outward turning of the lower eyelid (Ectropion)
- Eyes remaining partially open while sleeping
These complaints usually resolve after the effects of botox wear off.
If i have surgery, will my muscle contractions completely go away?
There is a 70-80% chance of success with surgery, but sometimes botox injections may still be necessary periodically after the surgery.