El blepharospasm is involuntary, jerky, and repetitive closing of the eyelids. This dystonia occurs due to the orbicular muscle contraction. People who suffer from it feel involuntary eye tremors.

There are three types of blepharospasms: twitches or tics, essential blepharospasm y hemifacial spasm.


El blepharospasm is involuntary, jerky, and repetitive closing of the eyelids. This dystonia occurs due to the orbicular muscle contraction. People who suffer from it feel involuntary eye tremors.

There are three types of blepharospasms: twitches or tics, essential blepharospasm y hemifacial spasm.

What is blepharospasm?

It is a involuntary contraction of the orbicularis oculi muscle that is repeated, causing atypical postures and movements. It is more common in women than in men, and it usually occurs after the age of XNUMX or XNUMX.

Benign essential blepharospasm or primary blepharospasm is a disorder that normally affects both eyes, in which the eyelids close involuntarily. In advanced cases, mouth or neck muscles are also affected by these spasms. These spasms disappear while the person sleeps.

When they occur, they can cause an impediment to vision, because the eyelids close involuntarily and do not let us see. These spasms are rare but very uncomfortable, and often disabling.

The essential benign blepharospasm is produced by abnormal impulses in the brain, causing abrupt contraction of the palpebral muscles or spasm. It is almost never due to a psychiatric illness.

These palpitations in the eye usually progress gradually, increasing in intensity and frequency over time. It can also produce visual disturbances.

Hemifacial blepharospasm

A hemifacial spasm is a condition in which the eyelid muscles are affected and usually the muscles around the mouth on only one side of the face. Hemifacial spasm is usually caused by pressure in an artery or nerve in the muscles of the face. A neurosurgical procedure will be able to solve this compression, freeing the affected artery or nerve.

All the botulinum toxin injections They can be beneficial to relieve patients with this type of pathology.

hemifacial blepharospasm


There are several factors that can trigger the appearance of this tic in the eye. Sometimes it can be caused by the patient's own habits, but they can also be due to previous ocular pathologies. 

Among the causes that usually cause these tremors in the eye The following are found:

  • Stress.
  • Fatigue.
  • Caffeine.
  • Excessive alcohol consumption.
  • Corneal irritation or the conjunctiva.
  • Functional neurological disorders in the central nervous system.
  • Insufficient lubrication on the surface of the eye, increasing the activity of the eyelid to try to distribute evenly the scarce or poor quality tear.

Despite all the causes listed above, there are cases in which it is not possible to determine the origin of the blepharospasm.

The cause of minor eyelid spasms is unknown. A slight spasm of the lower eyelid or both eyelids is common and usually not a cause for concern.

Minor eyelid contraction, as if it were a tremor in the eye, does not require treatment, as it resolves spontaneously. In these cases it is recommended reduce stress, and correct refractive defects, if they existed, through glasses or other optical system.

Symptoms of blepharospasm

Although the symptoms of blepharospasm are usually very obvious, it is convenient to know them in order to make a proper diagnosis:

  • Twitching or spasms of the eyelid that are repeated and cannot be controlled. They usually occur on the upper eyelid, but they may also occur on the lower eyelid.
  • Blurred vision.
  • Sensitivity to light.
  • Forcibly closing my eyes, trying to make the shaking go away.
  • Loss of vision, only in the most serious cases.

If facial spasms are severe, they can cause problems speaking or eating The patient may also have serious difficulties reading, driving, watching television, as well as doing other normal day-to-day activities.


Prevention if you have eye spasms

Although it is not possible to actually prevent blepharospasm, proper diagnosis is important. Sometimes patients can confuse the symptoms of this condition with other diseases that also have abnormal eye movements.

There are a significant number of cases in which this tic in the eyelid is associated with a problem of ophthalmological origin, but it is actually a neurological problem. On the other hand, if these tremors begin in childhood, they usually spread to other muscle groups.  

Making a diagnosis of blepharospasm as soon as possible is essential, since in this way we will avoid complications related to this eye tremor.

On the other hand, it is essential that the ophthalmologist distinguish blepharospasm from certain diseases from the eyes like corneal pathologiesDry Eye o glaucoma.

As a general rule, if you have eyelid spasms it is important to adopt certain habits to improve it, as the following:

  • Consume less caffeine.
  • Sleep more hours.
  • Lubricate the eyes applying drops. 
  • Wear sunglasses.

Blepharospasm treatment

There are currently two procedures to treat blepharospasm:

  • Botox injection.
  • Operations blepharospasm.

Botox injection

In those cases in which the tremor in the eye persists, one of the treatments that offers the best results is the Botox treatment. This procedure consists of inject small amounts of Botulinum toxin in the muscles around the eye, especially in the orbiculars and corrugators.

blepharospasm which is

Esto relax the muscles for a few months. There are no systemic effects using botulinum toxin and its effectiveness is very high, although its effects are only temporary, necessary repeat the injection every 3 to 4 months. Sometimes certain side effects may also appear, although very discreet, such as ptosis, the inability to close the eyelids with tearing or irritation and rarely blurred vision or double vision.

Patients with blepharospasm are occasionally treated with drugs, but the results are not very good.

Blepharospasm surgery

In more severe cases the blepharospasm treatment most recommended is the surgical. There are two types of surgery possible for essential benign blepharospasm. One is based on the destruction of the innervation of the muscles. This produces improvement, but sometimes the relief is incomplete and the situation is reproduced. Another different type of surgery is based on the removal of muscles that produce spasm, Also known as myectomy of the orbicularis oculi and depressor muscles. This operation consists of completely or partially removing the fiber from one of the muscles of the upper eyelid, thus preventing it from closing due to spasms. This can achieve marked improvement but is a major surgical procedure and the results are often variable. After a myectomy, there is the possibility of continue injections botulinum toxin.

On the other hand, the effects of surgical procedures including the widening or lowering of the upper eyelid (ptosis), temporarily disable the complete closure of the eyelids, (which may result in some dryness or irritation of the eye), and more rarely blurred vision or loss of vision.

Eyelid spasms
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Eyelid spasms
There are three very common types of palpebral spasms: nervous contractions or tics, essential blepharospasm, and hemifacial spasm.
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Área Oftalmológica Avanzada
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