Blepharospasm is the medical name for a twitching eyelid. The name comes from the words “blepharal,” which means relating to the eyelid, and “spasm,” which is an involuntary muscle contraction.
Doctors divide blepharospasm into two types: primary and secondary. Primary blepharospasm is not associated with another underlying health condition. Secondary blepharospasm is when another health condition causes it.
Most cases of blepharospasms are secondary and go away by themselves. Causes are usually minor and include:
- lack of sleep
- too much caffeine
- strenuous exercise
Benign essential blepharospasm is a rare progressive neurological condition that affects about
It causes progressively worse eye twitching in both eyes. Severity varies significantly among people. It may be mild or can be severe enough to affect a person’s quality of life.
This article will focus on benign essential blepharospasm.
Benign essential blepharospasm is part of a group of movement disorders called dystonia. Dystonia is characterized by involuntary muscle contractions.
Experts do not fully understand the cause of benign essential blepharospasm.
Gene mutations may play a role, given that about
Other factors that may play a role include:
- neurotransmitter dysregulation
- structural damage
- face trauma
- previous eye disorders
- other neurological movement conditions such as Parkinson’s disease
Medications that treat Parkinson’s disease can also cause blepharospasm.
Some medications can cause eyelid twitching. It’s a form of secondary blepharospasm, but it isn’t directly due to another health condition. Medications linked to drug-induced blepharospasm include:
Inherited genes that scientists think play a role in its development include:
- living in an urban environment
- working a “white collar” job associated with a stressful lifestyle
- frequent reading or looking at a screen
The same 2022 research notes that about 40% to 60% of people have eye symptoms that happen before blepharospasm starts.
These symptoms include eye:
Some mental health conditions seem to be linked to a higher risk of blepharospasm. They include:
Benign essential blepharospasm almost always affects both eyes, according to the National Organization for Rare Disorders.
Spasms usually occur during the day and disappear at night while sleeping. They also may temporarily go away during activities like:
The early stages of the condition are usually characterized by an increased blinking rate worsened by stimuli such as:
- bright lights
- emotional stress
- wind and pollution
It may become harder to keep your eyes open over time as the condition progresses.
Symptom severity widely varies among people, according to
Spasms may spread to the lower face, mouth, or jaw. When this happens, it’s called Meige syndrome. It may cause symptoms such:
- jaw clenching
- tongue protrusion
When to seek medical help
National Eye Instituterecommends seeing a doctor if:
- Your eyelids twitch for more than a couple of weeks.
- Your eyelids close completely when they twitch.
- You develop twitching in other parts of your face.
No laboratory tests can help doctors diagnose benign essential blepharospasm. It can be difficult to get a definitive diagnosis. A Japanese study reported that
The diagnostic process usually starts with your primary doctor. They will perform a physical exam and consider your medical history.
If they suspect an eye concern, they may send you to an eye doctor. An eye doctor can examine your eyes to look for structural problems and help rule out other conditions.
Once a doctor rules out structural problems in your eye, they may refer you to a neurologist for further testing. A neurologist may perform tests such as an electromyogram to measure your muscular activity and a nerve velocity test to measure how quickly electrical information is moving through your nerves.
Doctors treat most cases of benign essential blepharospasm with botulinum toxin (Botox) injections to relax your muscles. These injections are made from a toxin produced by Clostridium botulinum bacteria.
Some people experience side effects from these injections, such as:
The side effects are usually temporary.
Other treatments that doctors have used to treat benign essential blepharospasm with limited success include:
- medications such as benzodiazepines, anticholinergics, and levodopa
- protractor myectomy, which is the removal of part or all the eyelid muscles
- deep brain stimulation
tinted lensesto reduce symptoms of light sensitivity
Reducing stress and minimizing eyestrain by limiting screen time may help you manage your symptoms.
Did you know?
It was an ophthalmologist, Dr. Alan Scott, who
According to the
The outlook for benign essential blepharospasm is highly variable. It ranges from a mild inconvenience to a severe condition that can affect quality of life. Some people can develop functional blindness because their eyes stay closed for hours at a time.
In some cases, the condition worsens or spreads to surrounding muscles. In other cases, it stays the same for years or can even resolve itself spontaneously.
Here are some frequently asked questions people have about benign essential blepharospasm.
Is there any way to prevent benign essential blepharospasm?
There’s no known way to prevent benign essential blepharospasm. Reducing eyestrain and stress may help you manage your symptoms.
Can blepharospasm be a sign of a brain tumor?
Some brain tumors can cause eye twitching. For example, in a
How long do Botox injections for blepharospasm last?
Botox injections start taking effect within a few days and can last 2 to 3 months. After multiple Botox injections, the affected muscles may waste away. Symptoms of benign essential blepharospasm may resolve to the point where you no longer need Botox.
Botox injections are effective in about 70% of people with blepharospasm.
Are people with blepharospasm allowed to drive?
If twitching is severe and causes your eyelids to close completely, it may not be safe to drive. In severe cases, spasms may lead to your eyelids being closed for hours at a time and potentially legal blindness.
Blepharospasms are twitches of your eyelids. Most cases are minor and temporary, but some people have a condition called benign essential blepharospasm that can lead to severe spasms in both eyes.
Doctors aren’t exactly sure what causes benign essential blepharospasm, but genetics may play a role.
It’s a good idea to visit your doctor if your eyes close completely when twitching, you develop twitches in other parts of your face, or if twitches persist for more than a couple of weeks.