Medical & Surgical Ophthalmology

Oculoplastic

Blepharospasm

What is blepharospasm?

Blepharospasm is part of a group of conditions called dystonias, which are disorders of muscle tone and movement.

Specifically, blepharospasm is a spasmodic (rapid), involuntary and repetitive contraction of the orbicularis muscle (the muscle that surrounds the eye, responsible for closing the eyelids).

It must be differentiated from hemifacial spasm, which is not dystonia, but affects the muscles on one side of the face, and may affect the eye.

Why does blepharospasm occur?

Among the facial dystonias, blepharospasm is one of the most frequent.

It can be caused by:

How does blepharospasm manifest?

Blepharospasm manifests itself with uncontrollable blinking, forced closing of the eyes, associated contraction of other muscles (neck, head or mouth). These contractions only disappear when the patient sleeps.

If the closing of the eyelids is severe, blepharospasm may be accompanied by decreased vision.

Blepharospasm treatments

The sun and dry eyes can worsen cases of blepharospasm, so the use of sunglasses and lubricating drops can help improve symptoms.

On the other hand, in more serious cases or those that do not respond to the previous treatments, botulinum toxin can be used to relax the muscles and prevent their contraction. However, this treatment is temporary and must be performed repeatedly.

In already severe cases, surgical treatment can be performed: myectomy of the orbicular muscle or orbiculectomy, which consists of partially or totally removing the fibers of this muscle, to prevent it from continuing to close.

Blepharospasm prevention

Blepharospasm cannot be prevented, but it is important to diagnose it early.

It is important to control it in childhood, since dystonia frequently spreads to other muscle groups, and to avoid the complications associated with repeated postural movements derived from dystonia.

Summary

Debut

There is no specific age of presentation, but in childhood there is a risk that the disease will increase.

Symptoms

Involuntary and uncontrollable blinking, forced closing of the eyes, contraction of other muscles of the neck, head and face, in severe cases it can be accompanied by decreased vision. The contractions disappear when the patient sleeps.

Revision

It is important to visit the ophthalmologist frequently for early detection.

Prevention

It cannot be prevented, but it is important to diagnose it early.

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