- Do you experience uncontrolled blinking of your eyes?
- Do your eyes sometimes completely shut and make you feel as if you are blind?
- Does it become difficult to even open your eyes on their own?
- Does this uncontrolled blinking and twitching of your eyes, cause pain in your eyes?
- Do you know this condition can have severe consequences if it persists and can lead to visual impairment?
This condition of uncontrollable eye blinking and twitching is called Benign Essential Blepharospasm or BEB.
Benign Essential Blepharospasm- What it is?
Blepharospasm is the term used to describe the set of conditions characterized by uncontrollable closure of the eyelids and blinking frequently. Blepharospasm is a kind of focal dystonia (neurological problem) in the eyelids, which means that a particular set of muscles in your body (in this case, the eyelid muscles) undergo muscular contractions without your control. The cause of dystonia is thought to be the misfiring of neurons in a part of the brain called the sensorimotor cortex. This debilitates the ability of the brain to control certain inhibitory mechanisms, resulting in unintended muscular contractions. Simply put, there is an imbalance between the muscles causing eye closure and eye opening. The eye closure muscles force closure of the eyelids, due to a neurological problem. Hence, the problem with the person having Blepharospasm is not with the eyes or the vision of the person. It is with the movement of eyelids, brought about by muscular contractions.
Treatments for Blepharospasm
Different drugs have been used which have varying effects, but all these drugs have a limited efficacy. Lithium and diazepam (valium) are sometimes used. Tetranbenazine has shown some benefit in some patients. However, drugs may work on one patient and not on another, so, there is no standard treatment regime. Moreover, oral medications have many side effects and this in turn can create more issues for the patient.
Botulinum toxin injections (BOTOX Injection Treatment):
Botulinum toxin is obtained from the bacteria Clostridium botulinum. It causes disruption of nerve messages to the muscles and thus prevent muscle contraction. Toxin injections are given to the patient at 4 to 8 sites around each eye. The injection shows its effect 2- 3 days after administration, reaches maximum effect after 7-10 days and lasts for 3-4 months. After which there is a need for re-injection.
In general, botox injections are extremely safe and are the gold standard of treatment for all eye twitching disorders such as blepharospasm, hemifacial spasm and Meige’s syndrome. There can be some common side effects of using botox injections like dryness of eyes and double vision. Short-term blurry vision is also common. These side effects are temporary. Eye drops can be useful in preventing dryness of eyes. The eye drops are important also since dryness of the eyes can exacerbate the twitching of the eyes.
When the patients are poorly responsive to botulinum therapy, surgery is usually performed for the eyelid closing muscle (called the orbicularis oculi), which is called orbicularis myectomy. It involves removal of some of the upper eyelid and eyebrow muscles, which are responsible for squinting and closure of the eye. Sometimes upper eyelid surgery is followed by lower eyelid surgery also, if symptoms persist. 75 to 80 percent of people with blepharospasm have found this treatment very effective.
Full upper orbicularis muscle myectomy is performed by making an incision adjacent to the eyebrow hair, thus allowing access to the muscles of the upper lid and some of the brow muscles. Most of the muscle is removed, but a central part of the muscle is kept at the margin of the upper eyelid in order to retain voluntary closing of the eye. In limited upper myectomy, incision is made in the crease of upper eyelid and less eye muscle is removed from the upper lid only. After this treatment, some patient still requires botulinum toxin injections. Myectomy can be done under local or general anesthesia.
Recovery after surgery
In the post-surgical period there is swelling, bruising and redness due to blood accumulation in eye area, which may prevent full eye opening. Cold compresses should be given for 4 to 5 days to reduce swelling. It may take up to 6 months to 1 year for complete healing process after myectomy.
Watch the video of a patient with Blepharospasm treated with botox Injections:
Botulinum Toxin InjectionsBotox Treatment (Botulinum Toxin Injections) Blepharospasm & Hemifacial Spasm, Mumbai, India
FAQs (Frequently Ask Question)
Do all patients experience exactly same symptoms?
Not exactly! The symptoms, along with the uncontrolled eye closure, can be associated with facial spasms, dryness and irritation of the eyes. Even worse symptoms may be experienced on sunlight exposure or bright indoor lights.
What factors can contribute to Blepharospasm?
Various factors are known to contribute to Blepharospasm and include stress, fatigue and irritation.
Are the people having Blepharospasm blind?
The inability to open eyes, though the eyes are perfectly normal, causes functional blindness in the affected people since they cannot open their eyes; great effort is needed to successfully opening of eyes hence for certain timespan the person cannot see.
How to distinguish Blepharospasm from hemifacial spasm?
Blepharospasm and hemifacial spasm are completely different diseases. While in hemifacial spasm, the symptoms are limited to one side of the face (leading to the patient complaining that he cannot open the right eye or the left eye); in blepharospasm, the symptoms occur on both sides. There is associated facial twitching on the same side of the face in hemifacial spasm, something which is not there in blepharospasm.
Blepharopasm Surgery Before After Photos
What is the cost of Blepharopasm Surgery?
It is often said that eyes are the window to the soul. Any imperfections relating to the eyes are not only very prominent, but also very inconvenient as they may cause irritation, tearing and poor vision. Cosmetic surgery is one way of ensuring the correction of imperfections and flaws. Blepharospasm treatment can be surgical or non-surgical, by means of which uncontrollable twitching of the eyelid can be controlled.
Surgical procedures are associated with medical and recovery costs. In India, high quality medical care is available without the astronomical costs that cover medical procedures in countries like UK, USA and Singapore. The cost of blepharospasm treatment depends on the type of treatment required by the patient. You should discuss the types of treatments and their costs with your doctor thoroughly before embarking on a treatment plan.
The Esthetic Clinic is involved in every step of your cosmetic surgery journey, from start to finish. Our head surgeon, Dr. Debraj Shome, is a highly accomplished surgeon with extensive facial surgery experience. The highly-trained and friendly staff at the clinic will ensure that you feel reassured and comfortable throughout the course of your cosmetic surgery.
Dr. Debraj Shome is a highly trained facial plastic surgeon and Oculoplastic surgeon having received training from the best institutes in the world. He is extremely skilled with treating eyelid and facial abnormalities, including benign essential blepharospasm (BEB), hemifacial spasm, Meige’s syndrome and other cervico-facial dystonias. Both surgical techniques and non-surgical methods for blepharospasm treatment are available at the The Esthetic Clinic. In case you need treatment for blepharospasm, The Esthetic Clinic is well-equipped to help you.
About Dr. Debraj Shome
Dr. Debraj Shome – Founder, The Esthetic Clinic, is a top facial plastic surgeon. Dr. Shome is currently a Consultant at the best Mumbai hospitals like Saifee Hospital, Breach Candy Hospital, Holy Family Hospital & Nova Specialty Hospital in Mumbai, India. He has 40+ research papers in international journals, numerous presentations at conferences & many awards such as “Best Plastic Surgeon in Mumbai”, “Top 10 Cosmetic Surgeon in India”, Best Oculoplastic Surgeon India”, etc. A celebrity plastic surgeon, Dr. Shome believes plastic, reconstructive & cosmetic face surgery can allow you to lead a more fulfilled life …Read more
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