What is blepharospasm?

People with benign essential blepharospasm (sometimes called BEB) have involuntary muscle contractions and spasms in the eyelid muscles. Light sensitivity (photophobia) is also a common symptom. In one study, 80% of patients said that bright lights, watching TV, driving, reading, and stress can worsen symptoms. Blepharospasm is a neurological disorder that progresses through a person’s life. It is a form of dystonia, which are disorders characterized by involuntary muscle contractions. Both men and women can have blepharospasm, but it is more common in women who are middle-aged and older.

How do symptoms changes as blepharospasm progresses?

In the early stages of blepharospasm, people notice that they blink more frequently when their eyes are irritated. They may find that keeping their eyes open becomes more difficult and experience photophobia. As blepharospasm progresses, the increasing frequency and severity of spasms may force eyelids to remain closed, thus interfering with vision. The spasms can cause functional blindness, which is not a problem with the eyes, but stems from the closing of the eyelids.

How is blepharospasm treated?

Botox injections are the primary treatment of blepharospasm and provide many patients with substantial relief. Potential, usually temporary, side effects include drooping eyelids, blurred or double vision, and eye dryness. A surgical procedure to remove some of the eyelid’s muscles and nerve endings, called myectomy, is also frequently effective. Medications have limited effect. Glasses with FL-41 tint reduced functional limitations, blink frequency, and photophobia in a 2009 study. The study also found that FL-41 lenses were more effective than gray lenses at reducing fluorescent light sensitivity, overall light sensitivity, spasm frequency, and spasm severity. FL-41 also provided participants with more relief when reading.

What is the prognosis for blepharospasm?

Blepharospasm is considered a progressive disorder and symptoms tend to worsen or spread to surrounding muscles. However, some people’s symptoms remain stable for many years and a small number have experienced spontaneous improvement.

Learn more about light sensitivity and photophobia

REFERENCES

National Institutes of Health: Facts About Blepharospasm (https://www.nei.nih.gov/health/blepha/blepharospasm). Retrieved Oct. 19, 2015.

Doran M. Photophobia: Looking for causes and solutions. Eyenet Magazine Nov. 2005.

Blackburn MK, Lamb RD, Digre KB, Smith AG, Warner JE, McClane RW, Nandedkar SD, Langeberg WJ, Holubkov R, Katz BJ. FL-41 tint improves blink frequency, light sensitivity, and functional limitations in patients with benign essential blepharospasm. Ophthalmology. 2009 May;116(5):997-1001.