The cause is not fully understood, but is believed to be due to abnormal brain signalling in a part of the brain called the basal ganglia. Sometimes it could be due to irritation of a nerve by a dilated blood vessel, associated with dystonias or even dry eyes. When the cause is unknown, which is in the majority of cases it is called Essential Blepharospasm.
The symptoms can be mild with intermittent blinking to severe spasming of the eyelids leading to an inability to open the lids. This can be extremely distressful and can also be dangerous, especially while driving.
Treating essential Blepharospasm is not easy.
Before embarking on treatment is important to complete a thorough ocular and facial examination, sometimes neuroimaging in the form of an MRI or a CT scan may be needed.
Depending on the severity of symptoms, conservative measures like, ocular lubricants, tinted glasses, tapping the temple with a finger or trying relaxation techniques may help.
More severe Blepharospasm is treated with botulinum toxin injections into the affected muscles. The effect of the injection is seen between 2-7 days depending on the toxin used. The correct dose may take a few attempts to get correct with the effect lasting from 2-6 months. It then needs repeating at regular intervals. The risks of Botulinum toxin injections for blepharospasm are under correction, over correction resulting in droopy eyelids or double vision, bruising can also occur.
Surgery in the form of orbicularis stripping, can be offered in extreme cases, but it is not without its risks.
If you suffer from Blepharospasm, you need to inform the DVLA.
It’s natural to feel anxious when it comes to treatment and surgical procedures especially in relation to your eyes. I encourage you to ask questions about your condition, so I can help you to be better informed of your condition, the treatment options available and allay any fears that you may have. During the consultation I will explain the procedures to you and help you to make positive choices, and remember there is always the option of doing nothing, so you have nothing to worry about.
