​Blepharospasm

Blepharospasm is a type of dystonia (that is, a disease in which your muscles contract involuntarily) causing uncontrollable repetitive or twisting movements. Blepharospasm affects the eyes, and is also known as eye dystonia. It is uncontrollable and often causes painful muscle contractions around the eye.

Blepharospasm is classified as a focal dystonia, meaning that it affects only one region of the body, which is true for majority of the cases. However, in a few rare cases, it does spread to other regions of your body and in that case it is classified as a multifocal or segmental dystonia. The best documented of these is Meige's syndrome, that is, eye dystonia, combined with mouth, jaw or tongue dystonia. This disease usually affects people between the ages of forty and seventy but it does sometimes affect younger people as well. It is also more likely to affect women than men. ​

As blepharospasm affects the eye muscles, it usually begins with excessive blinking, dry eyes and eye irritation that is aggravated by wind, air pollution, sunlight, and other irritants. It starts gradually, and in the early stages, usually occurs with specific stress inducing factors such as bright lights, fatigue, and emotional tension. The symptoms start with one eye but almost always spread to both eyes.

As the disease progresses, you may start experiencing symptoms more frequently. They disappear when you are asleep, and usually do not appear for several hours after waking up if you are well rested. You will also have increasing difficulty keeping your eyes open, which can lead to severe vision impairment.

If you are feeling excessive irritation in and around the eyes, or are experiencing any of the other symptoms listed above, it is recommended that you consult with your doctor working with the Eye and ENT Service Line immediately. You can obtain additional information and expert medical advice from the medical staff at the Mind and Brain Service Line at The Aga Khan University Hospital.

Your time with your doctor may be limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started.

Blepharospasm is sometimes misdiagnosed by General Practitioners, as it is commonly mistaken for:

  • Dry eyes

  • Eye strain, tired eyes or tics  

  • Psychological problem

However, if you do not respond to any of the treatments for the above conditions and feel that wearing dark glasses usually eases your symptoms, consult with a neurologist (brain specialist) or ophthalmologist (eye specialist). 

There are no medical tests for proving the exact diagnosis of blepharospasm, but some tests may be conducted to rule out other possible problems. Diagnosis of blepharospasm is based on personal information and physical and neurological examinations. These may include tests for allergies or dry eyes or in some cases, brain scans. 

There is currently no cure for blepharospasm but in the vast majority of cases, blepharospasm does not impact other aspects or shorten your life span. You can manage to develop successful strategies for living with dystonia by combining treatment with pain management.

One type of treatment involves regular injections of botulinum toxin (commonly known as Botox). This substance is injected using a tiny needle on the affected nerve and acts as a muscle relaxer. Sometimes oral medication (such as clonazepam, lorazepam and trihexyphenidyl) can also be prescribed.

In some cases, you may find relief by applying light pressure to particular points on your face. Wearing dark glasses or wearing a hat can also contribute to easing the pain. Eye crutches can help in adequate opening of eyes.

A more uncommon treatment option is a surgical procedure known as myectomy, during which some or all of the muscles responsible for eyelid closure are removed. It has proven to be the effective in many cases but is not recommended unless you do not respond to any other types of treatment and are aware of the risks of eye surgery. 

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the 'Important Numbers' section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments' costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the 'Important Numbers' section on the website homepage.

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the 'Important Numbers' section on the website homepage.



The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider. ​