An eyelid spasm, also called blepharospasm, is forceful, involuntary closing of the eyelids. Often it affects both eyes, but it can affect only one. As the condition worsens, the blinking or winking happens more often. The eyelids may remain forcefully closed for several hours at a time, which may cause vision problems. Blepharospasm may also involve the forehead or the muscles around the mouth.
Blepharospasm is quite different from the mild twitches of the lid that sometimes happen with stress, use of caffeine, or lack of sleep and do not affect vision.
The exact cause of eyelid spasms is not known. Many experts believe that the condition is related to a problem in a part of the brain that coordinates muscle movement (the part of the brain called the basal ganglion). In most cases, the condition is not caused by any other disease and is called essential blepharospasm. Blepharospasm sometimes seems to run in families.
Medicines, such as those used to treat Parkinson's disease, may cause this problem. Other factors may play a part in this condition, including:
In the past, eyelid spasms were thought to be a psychiatric problem, but now we know that is not true.
The symptoms are:
Your healthcare provider will ask about your symptoms and examine your eyes. In rare cases, you may have an MRI or CT scan to check the nerves that control facial muscles.
The main forms of treatment are:
Very small amounts of botulinum toxin A can be injected into the muscles that close the eyelids. This may weaken or stop the muscle spasms for several months. The shots usually need to be repeated about every 3 months, although the effects of the shots last longer than this for some people.
Medicines taken by mouth may also help to control the muscle spasms. The benefits may not last very long. You will need to work closely with your provider to find out what medicine and dosage work for you. Ask your provider about the latest research on medicines to treat eyelid spasms.
Some medicines cause spasms. Stopping these medicines or reducing their dosage may stop the spasms.
If neither the shots nor the medicines taken by mouth stop the spasms, you may need surgery to remove some of the muscles that close the eyelids. This surgery (called myectomy) can weaken or stop the spasms. Myectomy can result in pain, scarring, and may not correct the problem. Therefore, myectomy is only done as a last resort.
Bright light may make spasms worse, so wearing dark glasses may reduce some spasms. Also, dark glasses make the problem less noticeable to others.
Support from support groups, family, and friends can be reassuring and may help you stay active.
You may need treatment for blepharospasms for the rest of your life. However, proper treatment can control your symptoms.
Usually blepharospasm cannot be prevented.
