Eyelid Spasm (Blepharospasm)

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KEY POINTS

• An eyelid spasm, also called blepharospasm, is forceful blinking or winking of your eyelids that you can’t control.
• Treatment depends on the cause. Treatment may involve medicines, surgery, or avoiding bright light.

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What is eyelid spasm?

An eyelid spasm, also called blepharospasm, is forceful blinking or winking of your eyelids that you cannot control. Often it affects both eyes, but it can affect only one. As the condition worsens, the blinking or winking happens more often. Blepharospasm may also involve the forehead or the muscles near your eyes.

Blepharospasm is different from mild twitches of your eyelid that may happen with stress, eyestrain, or lack of sleep. If you have blepharospasm, your eyelids may stay forcefully closed for several hours at a time, which may cause vision problems.

What is the cause?

The exact cause of eyelid spasms is not known. It may be a problem with the part of the brain that controls muscle movement. You may be more likely to have eyelid spasms if you have:

• A family history of muscle spasms in any part of the body
• Dry eyes
• Parkinson’s disease
• Wilson’s disease

Some medicines, such as those used to treat Parkinson's disease, may also increase your risk.

What are the symptoms?

Symptoms may include:

• Winking, blinking, or squinting that you cannot control
• Trouble keeping your eyes open

Symptoms usually go away when you sleep, and may get worse with stress, reading, being in bright light, watching television, or driving.

How is it diagnosed?

Your healthcare provider will ask about your symptoms, medical history, and activities, and examine your eyes.

How is it treated?

Treatment depends on the cause. You may need treatment for blepharospasms for the rest of your life. However, proper treatment can control your symptoms.

• For some causes of eyelid spasms, a very small amount of a medicine called botulinum toxin A can be injected into the muscles that close your eyelids. This may weaken or stop the muscle spasms for several months. The shots need to be repeated to keep spasms under control.
• Medicines taken by mouth may control the muscle spasms for a short time, but they may cause other side effects. Talk with your healthcare provider about this.
• You may need surgery to remove some of the muscles that close your eyelids. This surgery can weaken or stop the spasms.
• If a medicine is causing the spasms, stopping or reducing the dose of the medicine may stop the spasms.
• If bright light makes your spasms worse, your provider may suggest that you wear dark glasses indoors as well as outdoors.
• If dry eyes trigger eyelid spasms, your provider may recommend drops or ointment to keep your eyes moist.

How can I take care of myself?

Follow the full course of treatment your healthcare provider prescribes. Ask your healthcare provider:

• How and when you will get your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent eyelid spasms?

Usually blepharospasm cannot be prevented.