Blepharospasm is an involuntary contraction of the muscles around the eyes. The cause is unknown, it is presumed to be a brain disease similar to Parkinson’s. It is usually treated with Botulinum Toxin (Botox) injections. However, myectomy surgery is frequently necessary in those cases that don´t respond well to Botox. It is a highly specialized surgery that lasts no longer than 90 minutes and is performed exclusively by oculo-facial plastic surgeons. Full recovery will take up to 6 months, but the spasms will go away immediately after surgery.
What you should know about Blepharospasm
Blepharospasm affects both eyes. There is difficulty opening the eyes, excessive blinking, and squeezing of the eyelids and brows. The spasms disappear while sleeping and are usually worse with bright lights. When there are also spasms of the mouth and neck, the condition is called Meige Syndrome.
Patients are recommended to wear sunglasses. A special tint for the lenses, the FL-41, has been proven to be the most effective for decreasing light sensitivity.
It is also very important to keep the eyes lubricated. A simple office procedure called punctal occlusion, blocks one of the two tear ducts in each eye to help preserve the tears longer.
Botox (botulinum toxin) is selectively injected into those muscles that cause the spasms. This will relax them and allow the patient to open the eyes. The injections have to be repeated every 3 months, on average.
Myectomy surgery is the permanent and most effective treatment for Blepharospasm. It removes the muscles around the eyes responsible for the spasms. An upper eyelid skin crease incision allows the removal of the muscles involved (orbicularis oculi, corrugator and depressor supercilii) without leaving a scar. The patient satisfaction rate is over 90%. Few patients may still require Botox but in smaller doses and only in the lower eyelids.
Myectomy surgery is usually performed under deep sedation or general anesthesia and takes about 90 minutes. The patient can go back home the same day.