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Blepharospasm is a condition with involuntary closing of eyelids and trouble opening eyelids or keeping them open, typically affecting people beginning in their 40s, 50s or 60s.

Blepharospasm | Source: Merz

The initial symptoms may feel like squinting, eyelid heaviness, pain or tension around the eyes. If untreated, vision function can be affected simply because the eye closure interferes with vision (not because the condition affects the eyes themselves). Once treated, vision is entirely normal.

Triggers can include reading, walking, computer use and driving, which can be dangerous from a safety perspective, not to mention disruptive to the patient’s quality of life or even work-related activities. When blepharospasm is associated with lower facial dystonia, it is known as Meige syndrome.

Diagnosis and Treatment

Blepharospasm is diagnosed based on the clinical exam and is easily treated with injection of botulinum toxin (Botox or Xeomin). Botulinum toxin injections work by disrupting the communication between nerve and muscle, thereby relaxing the overactive muscles that cause blepharospasm. The treatment may take 3-10 days to kick in and typically lasts about 3 months, requiring repeat injection 3-4 times per year. The main side effects to be aware of are the possibility of weakness of eyelid closure, dry eye, eye tearing, with very rare possibility of eyelid droop or double vision. That being said, Botox is very safe and effective for blepharospasm and can be life-changing for patients, especially those who have gone undiagnosed for a while.

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Last updated: April 6, 2020