Blepharospasm (involuntary eyelid spasm)

What it is

Blepharospasm is a type of focal dystonia where the muscles around the eyes contract uncontrollably. Unlike a brief, minor eyelid twitch, it causes repeated forceful blinking or sustained closure that can, in severe cases, make it hard to keep the eyes open.

Common symptoms

Symptoms usually affect both eyes and build up gradually.

• Frequent, forceful blinking you cannot control
• Eyelids squeezing shut, sometimes for seconds at a time
• Symptoms worse with bright light, stress or tiredness
• Increasing difficulty with reading, driving or watching screens

Causes and triggers

The exact cause is not fully understood but involves abnormal signals from the part of the brain controlling movement. It is often made worse by bright light, fatigue, stress, and dry eye, which is why treating dry eye can help.

Treatment

The main treatment is regular botulinum toxin (Botox) injections into the eyelid muscles, which relax the spasms and are repeated every few months. Managing dry eye, using tinted glasses for light sensitivity, and reducing triggers also help, and surgery is reserved for severe cases.