Blepharospasm is a neurological condition that causes repeated, involuntary muscle contractions around the eyes and eyebrows. For some patients, these spasms are mild and intermittent, while others may experience frequent eyelid closure that interferes with reading, driving, working, and daily activities.
At Fante Eye & Face Center, patients from Denver, Greenwood Village, and surrounding Colorado communities receive blepharospasm evaluation and treatment from doctors with specialized experience in eyelid function, facial nerve disorders, and oculofacial care. Dr. Robert Fante has published peer-reviewed research on blepharospasm treatment and has extensive experience with therapeutic botulinum toxin injections, while both Dr. Levitt and Dr. Huang are ASOPRS-trained surgeons and ASOPRS Candidate Members. Together, the team can help determine whether botulinum toxin, trigger management, supportive care, or surgery may be appropriate.
What is a Blepharospasm?
Blepharospasm is a disease characterized by repeated, involuntary muscle contractions around the eyes and eyebrows. Blepharospasm does not occur during sleep and is often worsened by stress, dry eyes, and bright lights. Blepharospasm can be disabling and was the original reason that botulinum toxin, commonly known as Botox(R), was developed for medical use in the 1980s.
What Causes Blepharospasm?
Unfortunately, the underlying causes of this condition are unknown. However, the disorder is often associated with basal ganglion dysfunction. The basal ganglion is the part of the brain that controls muscular movement. Some cases of blepharospasm seem to have a genetic component with patients having a family history of the condition.
Symptoms of Eyelid Spasms
This condition develops gradually. In the beginning, patients report excessive blinking and eye irritation caused by stress factors. These factors could be bright lights, fatigue, or distress. Blepharospasm is often presented in both eyes, and the symptoms progressively occur more frequently over time. Eyelid spasms do not occur while patients are sleeping, and people often report experiencing relief upon waking up. In the most severe cases, patients may not be able to open their eyes for hours.
Types of Blepharospasm
There are two types of eyelid spasms that people experience, primary and secondary.
- Primary Blepharospasm: This condition manifests spontaneously. The medical name for primary blepharospasm is benign essential blepharospasm. This means that the condition is non-threatening and does not have a known cause.
- Secondary Blepharospasm: The conditions is often caused by exposure to certain drugs or is developed in connection to other disorders. Disorders associated with eyelid spasms include Parkinson’s disease and Wilson’s disease.
Eyelid Spasm Treatment
Blepharospasm can often be treated with botulinum toxin. Botox(R) is a medication that can reduce involuntary muscle spasms around the eyelids and eyebrows by temporarily relaxing the targeted muscles.
Treatment is administered in the office using small amounts of botulinum toxin through tiny injections. Typically, no anesthetic is necessary. Because botulinum toxin treatment for blepharospasm is medically indicated, it is often covered by health insurance, although pre-approval may be required.
How Does Botulinum toxin Treat Eye Spasms?
The muscle-relaxing effect of botulinum toxin typically lasts about three to four months, and treatment can be repeated as needed. Rarely, surgery may be considered when botulinum toxin no longer provides enough relief.
Dr. Robert Fante’s research on the treatment of blepharospasm has been published in peer-reviewed medical literature, and the doctors at Fante Eye & Face Center have extensive experience evaluating and treating eyelid spasm disorders.
Who is a Good Candidate for Blepharospasm Treatment?
Blepharospasm is a medical disease and treatment is recommended for anyone whose life and activities are disturbed by the symptoms. Insurance coverage is usually available, although a pre-approval process may be required.
Patient Story
Eyelid Spasm Treatment Options
Treatment with Botulinum toxin injections reduces the spasm that closes the eyes and improves a patient’s ability to use the eyes for everyday life.
Alternative Blepharospasm Treatments
Although repeated botulinum toxin injections are the mainstay of treatment for most patients, other ancillary interventions can help. These vary in usefulness among different people, but generally include adding FL-41 Tint for eyeglasses, wearing a headband or hat, treating any dry eye, allergies, or blepharitis to avoid triggers, and practicing meditation. Patients often report small lifestyle changes that help them in the quarterly newsletter of the Blepharospasm Research Foundation (see BEBRF.org) and the Foundation is also a great resource for support groups, meetings, and research programs in Denver and around the US.
Related Disorders to Blepharospasm
Hemi-facial Spasms
Hemi-facial spasm is a related neurological disease in which only one side of the face is affected. Unlike blepharospasm, the lower facial muscles are also affected and mouth twitching is usually obvious. Also unlike blepharospasm, the facial spasm persists during sleep. No cause can be identified for most people, but a small number of patients have a dilated blood vessel inside the brain that pulsates and pushes on the facial nerve. For this minority, a neurosurgery operation can help. Instead, for everyone else, botulinum toxin is our best answer. Interestingly, the toxin lasts longer for people with hemi-facial spasm and injections are only needed 2-3 times per year.
Bell’s Palsy
Another uncommon problem is eyelid twitching after partial recovery from Bell’s palsy and other facial nerve injuries including trauma, acoustic neuroma surgery, and parotid gland surgery. Sometimes this occurs due to misdirected regrowth of the nerves so that the ones that are supposed to go to the lips instead go to the eyelids. The medical name for this is Aberrant Regeneration, and it can be frustrating. Again, botulinum toxin is usually the best answer.
Myokymia
Finally, the mildest and most common eyelid twitching experienced by many people is associated with stress, lack of sleep, and caffeine (think of final exams or a big project at work or a new baby). Usually, this is annoying but subtle, more noticeable to the person who has it than to their friends and family. The medical term for this is Myokymia, and fortunately, it usually resolves on its own when the stress improves. Occasionally, however, a persistent spell of this mild twitching can be treated with a small amount of botulinum toxin to “break” the pattern. Although insurance doesn’t cover it, the dose is small and usually doesn’t have to be repeated.
Frequently Asked Questions
Why Choose Fante Eye & Face Center for Blepharospasm Treatment?
Blepharospasm treatment requires precise knowledge of the eyelid and facial muscles because the goal is to reduce spasms while preserving comfortable blinking, eye protection, and natural facial movement. At Fante Eye & Face Center, our doctors evaluate symptom severity, eyelid function, dry eye triggers, facial movement patterns, and treatment history before recommending a plan.
The practice has specialized experience in eyelid disorders, facial nerve conditions, and therapeutic botulinum toxin treatment. Dr. Robert Fante has published peer-reviewed research on blepharospasm treatment, whileDr. Levitt and Dr. Huang bring fellowship-trained expertise in oculofacial plastic and reconstructive surgery to the practice.
Because blepharospasm may overlap with dry eye, light sensitivity, facial spasm disorders, or other neurologic conditions, our team can help determine whether botulinum toxin injections, supportive treatments, lifestyle adjustments, or surgical options may be appropriate.
Blepharospasm Botox(R) Consultation in Denver, Greenwood Village, Castle Pines and Highlands Ranch
If you are experiencing uncontrollable blinking, eyelid spasms, forced eye closure, or eye irritation related to blepharospasm, Fante Eye & Face Center can help evaluate your symptoms and treatment options. During your consultation, our doctors will assess your eyelid function, facial muscle activity, triggers, and treatment history to determine whether botulinum toxin or another approach may be appropriate.
To book a consultation with Fante Eye & Face Center in Denver, CO, serving patients from Greenwood Village, Castle Pines and the surrounding communities, call (303) 839-1616 today.