Blepharospasm (Benign essential blepharospasm, hemifacial spasm)

Blepharospasm is a condition which causes the muscles in control of the eyelids to contract involuntarily. It also goes by the names, benign essential blepharospasm and hemifacial spasm. Blepharospasm can cause the eyelids to close for prolonged periods of time, which effectively means that a person can be blind even though their eyes function normally. It is rare and it is estimated that only 16 to 133 per million people are affected by the condition. Blepharospasm is more common among women than men and tends to affect people over the age of 50.

What are the causes of blepharospasm?

The precise reason behind the emergence of blepharospasm is unidentified, though it is believed the condition may be caused by the irregular utility of the basal ganglia (an area of the brain). The basal ganglia are responsible for controlling movements and although it is not known what causes the basal ganglia to function abnormally, it is possible that there may be a disruption in the transmission of chemical messages in people who have blepharospasm.

Other causes of blepharospasm include:

• Injury to the brain.
• Negative reaction to medication.
• Neurological health conditions, such as Parkinson’s disease and multiple sclerosis.

In many cases no specific cause can be found and symptoms come on quickly without any pre-warning. In rare cases there is a family history of the condition.

Symptoms of blepharospasm

The first sign to develop is usually excessive blinking, which is followed by the eyes becoming irritated. Most people only experience symptoms in reaction to a trigger, such as a bright light, but spasms tend to happen more regularly as the ailment progresses.

Blepharospasm affects people in different ways. Some people may only experience mild spasms which cause increased blinking, while others may suffer painful spasms that can be disabling. If the condition becomes advanced and the eyelids close for long periods of time, this can make day-to-day life difficult.

How is blepharospasm treated?

There are various treatments that can be used to ease symptoms caused by blepharospasm. These include:

• Injections of botulinum toxin (commonly known as Botox): Botox helps to block the action of the muscles around the eyelids.
• Medication: the efficacy of medication for treating blepharospasm is uncertain and many people do not respond to drugs.
• Surgery: a procedure called a myectomy has been proven to be effective in most cases and the procedure involves removing some of the muscle tissue around the eyelids.
• Alternative therapies: some people choose to try alternative therapies, including acupuncture and hypnosis, but there is no scientific evidence to support the fact that alternative therapies work.

If blepharospasm is linked to taking medication changing the drug may ease symptoms. It is also advisable to avoid triggers, which include bright light, stress and feeling tired. Wearing sunglasses can help to protect your eyes in bright sunlight. If you suffer from stress your GP may advise you to try some stress management techniques to try and help reduce symptoms.