What is Blepharospasm

Blepharospasm is a sudden tightening (spasm) of the muscles around your eyes (orbicularis oculi).

It causes attacks of abnormal and uncontrollable blinking that come and go without warning. This type of abnormal muscle movement is called dystonia.

Dystonia usually affects both eyes, but it does not affect other facial muscles or other parts of the body. Blepharospasm does not cause vision loss or lead to other serious physical problems.

What are the causes?

Blepharospasm is caused by an abnormality in a part of your brain that is called the basal ganglion. The exact cause of the abnormality is not known. Stress, fatigue, eye irritation, or bright light may trigger attacks of blepharospasm.

What increases the risk?

You may be at greater risk for blepharospasm if you:

  • Have a family history of blepharospasm.
  • Are female.
  • Are 50–70 years old.

What are the signs or symptoms?

Eye irritation and dryness are the first symptoms of blepharospasm. Your eyes may also feel tired or irritated when they are exposed to bright lights. As blepharospasm gets worse, uncontrollable blinking becomes more frequent. Other eye symptoms may include:

  • Uncontrolled and tight closing.
  • Watering.
  • Dryness.
  • Eye muscle pain.
  • Gritty sensation.
  • Sensitivity to light.

How is this diagnosed?

Your health care provider may diagnose blepharospasm based on your symptoms and your medical history. Your health care provider may also do a physical exam to confirm the diagnosis. There are no blood tests or other tests to help diagnose blepharospasm.

How is this treated?

There is no cure for blepharospasm. Treatments that are used to manage the condition may include:

  • Botulinum toxin injections. Botulinum toxin is a substance that is produced by bacteria that cause muscle paralysis. Injecting this toxin into the muscles around the eye may control blepharospasm for up to three months. Injections are done with a tiny needle. They can be repeated as needed.
  • Medicines. These include muscle relaxants, sedatives, and medicines that are called anticholinergics. Treatment with medicine is less successful than using injections.
  • Surgery. If other treatments have not worked, you may need surgery to remove part of the orbicularis oculi muscles (myectomy).

Follow these instructions at home:

Several home care management strategies may help. You may have to try different techniques to find what works best for you. These may include:

  • Avoiding triggers that may bring on your attacks.
  • Resting and avoiding stress as much as possible.
  • Applying gentle pressure to the side of your eye or face. Sometimes this can stop an attack.
  • Doing a specific activity that can halt an attack. Examples include laughing, singing, yawning, and chewing.
  • Wearing dark glasses and a sun visor to protect your eyes from bright light.
  • Trying alternative treatments such as acupuncture, biofeedback, hypnosis, or meditation.
  • Going to sleep or taking a nap. Blepharospasm usually stops during sleep.

Contact a health care provider if:

  • Your attacks get worse or happen more often.
  • You are anxious or depressed because of your attacks.

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