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Our eyelids can sometimes suffer involuntary spasmodic contractions in the orbicularis oculi muscle. This twitching of the eyelids that people sometimes experience is a phenomenon known as blepharospasm. It may present itself in the form of uncontrollable blinking, forced eye closure and even, in severe cases, loss of vision.

Why does this happen?

Blepharospasm is one of the most common conditions causing involuntary muscle contractions. It can be caused by a functional neurological disorder in the central nervous system, side effects of certain medications, a lack of lubrication of the ocular surface or concussion.

The most common factors that can cause muscle spasms in the eyelid are fatigue, stress and caffeine. Most people experience this type of eyelid twitch from time to time and they find it very annoying.

If the problem begins in childhood it often extends to different muscle groups. Therefore, the key is early diagnosis and treatment of this condition, avoiding the complications associated with repeated abnormal postures.

Can blepharospasm be avoided?

It usually occurs in periodic episodes and it almost always goes away without any treatment after about a week. In the meantime, the following steps can help:

  • Sleep more
  • Drink less caffeine
  • Lubricate the eyes with eyedrops

If the facial spasms are severe or last a long time, they can be controlled with small injections of botulinum toxin.

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Blepharospasm can lead to complications such as permanent eye injury from an undiagnosed bruised cornea, but this is rare. However, it is advisable to contact a doctor in the following cases:

  • if blepharospasm persists longer than a week
  • if the spasms close the eyelid completely
  • if they affect other parts of the face
  • when there is redness, swelling or discharge from an eye or an involuntary fall of the upper eyelid

Treatments for severe cases

There are different ways to treat blepharospasm depending on the factor that has caused its appearance. The most common usually includes the use of sunglasses, lubricant treatments or drugs. Botulinum toxin injections are also prescribed as they serve to reduce the transmission of electrical impulses from the nerve endings to the muscles, relieving the spasms.

For those cases where the prescription of drugs does not improve the situation, there is a surgical technique called an eyelid myectomy. This surgery involves the total or partial removal of the eyelid’s muscle fibres. In this way the overactive nerve endings have no muscles to stimulate and the spasms are alleviated.

The correct treatment of blepharospasm should be performed by an ophthalmologist specialising in ocular plastic surgery.