Blepharospasm? How Botox™ can help

Many things may cause our eyes to twitch or blink without our control, one being a condition called blepharospasm. In this article, highly experienced aesthetic doctor Dayal Mukherjee provides more information about blepharospasm, how it’s treated, and how Botox™ may help.

What is blepharospasm?

Blepharospasm is uncontrolled forceful blinking due to involuntary eyelid muscle contraction that causes the lids to twitch, flutter, or blink uncontrollably. Blepharospasm is officially called benign essential blepharospasm (BEB). “Benign” indicates the condition is not life-threatening, and “essential” is a medical term meaning “of unknown cause". Blepharospasm usually starts with small eyelid twitches that happen every once in a while. Over time, the blinking may become more frequent and more forceful causing the eyes to close completely making every day-to-day activities harder to do like reading, watching TV, or driving.

Can blepharospasm go away on its own?

Eyelid twitches usually goes away on its own. Having eyelid twitching for a short period of time doesn’t necessarily mean you have blepharospasm. Lots of different things can cause the eyelid to twitch and some lifestyle changes like managing your stress, getting enough sleep, and cutting down on food or drinks with caffeine may help. Other self-help measures like wearing dark glasses can reduce bright light triggers and make the condition less obvious to others. Wrap-around glasses are most protective. Voluntary manoeuvres, such as pulling on or touching the eyelid, pinching the neck, talking, yawning, humming, or singing can be helpful.

How can Botox™ help?

Blepharospasm happens when the part of the brain that controls the eyelid muscles stops working correctly and sends excessive signals to the eyelid muscles. Botulinum toxin is an approved treatment for blepharospasm and works by blocking these signals and stop muscles twitching. 90 percent of patients treated with Botox™ obtain almost complete relief of their blepharospasm.

How long does it take for Botox™ to work for blepharospasm?

Small injections of botulinum toxin are used just under the skin. The injections usually take 2 to 3 days to start working, but may range from 1 to 14 days after the injection. As the effect is temporary and usually last for up to 3 months, the injections usually have to be repeated to control the excessive muscle contractions. Most people need to get further injections every 3 to 4 months.

What are the side effects or risks of Botox™?

Long-term follow-up studies have shown Botox™ to be a very safe and effective treatment. Side effects include, but are not limited to, drooping of the eyelid (ptosis), blurred vision, and double vision (diplopia). Tearing may occur. All are usually transient and recover spontaneously. Repeated treatments remain effective over a long period of time.

If Botox™ doesn´t work, what are the other treatment options?

Where vision is seriously impaired by severe eye closure, and in the event Botox™ injections fail, surgery like myectomy can be used to treat blepharospasm. In a myectomy, a surgeon will remove some of the muscle or nerve tissue from your eyelids to help stop the twitching.

If you are experiencing irregular eye twitching or blinking or would like more information, you can book a consultation on Dr Dayal Mukherjee's Top Doctors profile.