Blepharospasm: Treatment, Procedure, Cost and Side Effects

Eye twitch, Spasm Eyelid muscle spasm, Eyelid muscle cramp, Benign essential blepharospasm

An abnormal contraction of the eyelid is termed as Blepharospasm. It is a very common nerve disorder that can occur and disappear on its own within a few days without any treatment. But in some cases, this may last longer resulting in greater problems such as blinding. During this time, there is an involuntary and sustained contraction of muscles around the eyes, possibly due to fatigue, stress or any irritation owing to the presence of some foreign particle within the eyes. However, the exact reason for this disorder is yet to be discovered.

The symptoms of Blepharospasm include mild and infrequent twitches that may or may not increase over time to forceful and frequent spasms of the eyelids. If this continues over a prolonged period of time, then this can lead to functional blindness from temporary inability to open the eyes.

The treatments of Blepharospasm include drug therapy, certain injections, surgery and neuroplasty and this varies according to the severity of the condition. If Blepharospasm starts getting complicated then the first way to solve this problem is to give injections periodically. If the disorder becomes further critical, oral medications or drugs can be taken. Further complicacies can be handled by surgery and other methods. However, all these situations are quite rare, since Blepharospasm is cured on its own in most cases.

The treatment methods of Blepharospasm vary according to the need and complication of the disorder. Botulinum toxin injections like Botox and Dysport may be induced to treat this disorder. This is the most acceptable method of treating Blepharospasm among the patients and the doctors. Injections are given every three to four months and the dosage varies from 2.5 to 5 units per injection site and within 4 to 8 sites per eye. The medicines injected within the eye starts its action within 2 to 3 days and the peak effect occurs approximately at about 7 to 10 days. After a duration of 3 to 4 months, the time for repeating this treatment procedure can be predicted by the doctor.

The second line of treating Blepharospasm involves oral medication. Muscle relaxants and sedatives may be taken when a person suffers from Blepharospasm. Anticholinergics, tranquilising drugs and botulinum toxin are mostly used medicines that can be orally taken to treat Blepharospasm. Sometimes, usage of FL-41 tinted glass (rose coloured) can also be recommended to treat patients who have high photosensitivity.

People, who do not respond properly to such injections or oral drugs, must go for surgical methods to treat Blepharospasm. Protractor myectomy is the most common surgical method. This surgery is done on the orbital and palpebral orbicularis muscle in the upper eyelids, or simply removal of muscles that are responsible for closing the eyelids makes the need full. Surgical ablation of the facial nerve is sometimes considered very effective in the treatment of Blepharospasm.

Blepharospasm generally occurs after a person reaches the age of 40 years. Prior to this age, this disorder is not that critical in nature. This condition occurs more often in females than in males. Therefore, if Blepharospasm becomes too critical for people who have attained 40 years of age, then they are eligible for taking this treatment.

Most of the people, for whom the severity of Blepharospasm is low, can heal on their own and do not need to consult a doctor or undergo any type of treatment regarding the same.

There are serious side effects if the drug therapy related to Blepharospasm fails. Tranquilising drug overdose can lead to dizziness, disorientation, confusion, double vision, dry mouth, headaches, nausea, vomiting, tremors and convulsions. A very common side effect of Botulinum injections is ptosis or drooping of the eyelid. If further injections are given to cure ptosis, the control on spasms might be reduced. Botunlinum injection can also lead to bruises, ectropion, epiphora, diplopia, lagophthalmos and corneal exposure. Protractor myectomy surgery can sometimes lead to hemifacial paralysis. Thus it has to be kept in mind that the treatment of Blepharospasm should be taken from expert and experienced medical personnel only.

Though Blepharospasm can be treated quite easily in most cases, the symptoms of this disorder like excessive blinking, uncontrollable contraction of the eyelid or dryness of the eyes, may render a person incapable of activities of day to day life such as reading, writing or driving. This condition may even sometimes lead to psychological distress within the person. If this happens, the patient would require education, counselling and mental support. Such actions can be performed by family members, friends or even a professional psychologist or counsellor. This activity is regarded quite an essential part of the treatment. After surgery, there may be swelling, bruising, or redness due to blood accumulation around the eye that can prevent opening of the eye. Cold compresses should be given for 4 to 5 days to reduce such post-surgical swelling.

Most of the people who are affected by lower levels of Blepharospasm are cured within 3 to 4 days. However, those who are affected by complicated cases of Blepharospasm may require about 1 to 2 years in order to recover fully, especially those who are on medications and injections. People who have undergone surgery may take about 1 year to recover completely.

Cost of treatment of Blepharospasm varies according to the type of treatment taken by the patient. On an average, the cost of treatment for Blepharospasm ranges between Rs. 30,000 to Rs. 240,000 in India.

The treatment methods of Blepharospasm that involves surgery, medicines and drugs are not fully permanent, as this is a neurological disorder and can return even after treatment. Minor levels of Blepharospasm which do not require treatment can return often after 2 to 3 months and disappear on its own.