Blepharospasm (Eye Twitching) – Causes and Treatment

Blepharospasm Eye Twitching

What is blepharospasm?

Blepharospasm, likewise known as eye dystonia is the involuntary blinking, twitching or spasms of the eyelid muscles that usually last for a couple of days and disappear without treatments. 

How long does blepharospasm last?

In cases where symptoms last longer than a couple of days, those cases are chronic, persistent, and affect eyesight leading to functional blindness where eyes stay shut for a couple of days and have to be opened with great efforts. 

What are the symptoms of blepharospasm?

  • Intense uncontrolled twitching or blinking of the eye that usually occurs when exposed to bright light, sunlight or reading, watching TV, driving, having fatigue, or stress.
  • Photophobia – Regular dryness, burning, redness and itching of the eye
  • Forced eye closure
  • Decreased vision in severe cases

What causes blepharospasm?

Any of the following can cause blepharospasm:  

  • Genetic factor: Blepharospasm may be inherited. It is well known to run in families and is more common in women.
  • Benign fasciculation syndrome (BFS): this is a neurological condition that is characterized by involuntary fasciculation (twitching) of several muscles of the body. The most common muscles affected are those that control the eyelids, hands, fingers, arms, legs, and tongue.
  • Fatigue (tiredness): a state of physical or mental weakness with a lack of energy.
  • Sleep deprivation (insomnia)
  • Prolonged screen time
  • High caffeine consumption
  • Stress: This is the body’s reaction to mental, physical, or emotional change that requires an adjustment or response. Worry and stress is a normal phase of life that can be experienced from environmental factors, different life circumstances, and mental problems.
  • Dry eyes (Kerato-conjunctivitis sicca): occurs when tears are not enough to provide adequate moisture. Dry eyes can be caused by getting older, by autoimmune disorders such as scleroderma or intake of certain medications.
  • Anxiety
  • Medications such as prolonged use of benzodiazepines, estrogen replacement therapy, and antiparkinson drugs 
  • Multiple sclerosis
  • Mild traumatic brain injury (Concussions)
  • Meige’s syndrome
  • Asthenopia

How is blepharospasm diagnosed?

Blepharospasm is diagnosed by the physical examination, medical history evaluation by a doctor, usually an ophthalmologist or neurologist.

Blepharospasm treatment

At present, there is no cure for blepharospasm. But there are various treatments to control and ease the symptoms, which include: 

  • Rest and getting proper sleep For mild cases
  • Temporal use of botulism toxin (Botox)
  • Anticholinergics medications (trihexyphenidyl, procyclidine, scopolamine, ethopropazine, and orphenadrine)
  • Myectomy: This is a surgical procedure for the removal of some muscles and nerves that supports the eyelids to fix the spasm.
  • Sedatives (diazepam) are usually used for blepharospasm.

Note: Prolonged use of benzodiazepines may also worsen blepharospasm.

Can blepharospasm be prevented?

There are no specific ways to prevent blepharospasm. Although it is recommended to eliminate stress, reduce the drinks that provoke stimulation of the central nervous system such as coffee and stimulating tea. After a long work with a computer, it is better to do eye exercise. 

If you noticed that for whatever reason that there is an increase in your frequency of eye blinks or you need to make an effort to close your eyelids, then you should seek help from an ophthalmologist or neurologist. 

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