Initially, blepharospasm may involve the twitching of the eyelid. This becomes progressively worse. In some cases, the involuntary closure of the eye may be so severe that the patient’s eyelids need to be prised open by the doctor. 

Research shows that blepharospasm affects more women than men. However, it is not a common complaint, affecting only around 0.005% of people worldwide.

The exact cause is unknown, but it may be triggered by dry eye, stress, excess caffeine and some systemic medication. It may also be part of Meige syndrome which is a central nervous system disorder.

In some cases, blepharospasm is mild and infrequent and doesn’t warrant any treatment. However, in other cases it may severely impact a patient’s quality of life, and treatment is required.

1. The eye specialist will treat the patient’s dry eye with lubricants
2. Patients are advised to avoid triggers such as caffeine, stress, bright lights etc.
3. Botox injections work well in most patients. The effects can be seen after a few days, and last between 3-6 months. The Botox treatment will have to be repeated on a continual basis.  
4. Systemic medication such as muscle relaxants, and anti-epileptic drugs have also been prescribed for blepharospasm. However, they don’t have a high success rate 
5. Surgery for blepharospasm is not often performed, but may be required in cases that don’t respond to any of the other treatments available. Surgery involves the radical excision (removal) of the periocular muscle fibres

Like blepharospasm, hemifacial spasm is more common in women over the age of 40. It is characterised by involuntary twitching and contraction of muscles on one side of the face. Hemifacial spasm may be caused by injury to the facial nerve, a tumour or vascular lesion pressing on the nerve, or there may be no apparent cause.

Treatment for hemifacial spasm is the same as that for blepharospasm. However, the surgical treatment is slightly different. If there is a lesion compressing the nerve (and it is accessible), then a neurosurgical decompression may be performed.