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Blepharospasms are a progressive neurological disorder characterized by contractions and spasms of the eyelid muscles. This is usually a chronic condition more common in women, normally appearing after age 50. Eyes involuntary squeezing shut – versus normal blinking – are an indicator of blepharospasm. Conversely, if a person simply blinks repeatedly and involuntarily, the cause is more likely due to dry eye, pyschogenic conditions, or a temporary condition that can be resolved with medical care.

Blepharospasm is thought to be a result of miscommunication between the brain and the eyelid muscles. In most people this condition develops spontaneously, without any precipitating factors, usually affecting both eyes.

Blepharospasm usually begins with occasional eye blinking and twitching, and progresses into recurrent forceful closure of the eyelids. Though the eyes are healthy, functional visual impairment can result from an inability to keep the eyelids open. No definitive cause of blepharospasm has been determined, although it is usually exacerbated by stress, bright lights, fatigue, watching television, driving and social interactions. Sleeping, walking, talking, concentrating on a task and relaxation exercises may provide temporary relief of symptoms.

The most common form of treatment for severe blepharospasm is the injection of small amounts of botulinum toxin (Botox™) into the muscles around the eye. Botulinum toxin appears to be safe and effective, but the results are temporary so the injections need to be repeated every 3 to 4 months. Drug treatment, dry eye treatment, and stress management techniques may be effective in less severe cases.

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