Blepharospasm is a condition of involuntary closure of the eyes, caused by the contraction of the muscles surrounding the eyes.
Normally we blink at a rate of 10 to 20 times per minute (less frequently when reading). In patients with blepharospasm the blink rate is much faster and the tone of the muscles is increased. For some this can develop into an inability to open their eyes, for seconds (or even minutes) at a time, due to the muscles around the eyes clamping the eyelids shut. This can obviously have a significant impact on a person’s quality of life, as they are often unable to drive, watch television, read or work.
Most cases of blepharospasm occur spontaneously, and it is not fully understood why. In fact, until the middle of the 20th century blepharospasm was thought to be a psychiatric condition. It is now known to be a neurological (nerve cell) disorder – a problem with the blink reflex control centre. Sometimes it can occur as a result of another medical condition such as trauma, Tourette’s syndrome or as a result of certain medications.
Blepharospasm usually commences between the ages of 50 and 70, although it can occur at any age, and tends to affect women more than men.
Mild cases can often be managed conservatively, with a variety of measures such as using sunglasses (especially rose tinted ones), wearing a baseball cap, use of eye lubricants, and using a back-lit keyboard. However, the most effective treatment for tackling more significant cases is the injection of botulinum toxin, which will provide significant relief for 80% – 90% of affected individuals.
Botulinum toxins (such as Botox®, made by Allergan) block the nerve impulses to muscles, reducing the muscles’ ability to contract. For those suffering from blepharospasm, the procedure involves injecting tiny amounts of Botox® into the muscles around the edge of the eyelids. Treatment typically eases symptoms for up to 12 weeks, at which point the procedure would need to be repeated to maintain its effectiveness. If you would like more general information regarding Botox® this can be found on our Frequently Asked Questions page.
There are some extremely helpful resources available to those affected by blepharospasm, such as at blepharospasm.org and dystonia.org.uk. Whilst treatment with botulinum toxin is available on the NHS, some patients prefer the flexibility and comfort of privately funded treatment. I would be happy to discuss the suitability of treatment with you at an initial consultation, the cost of which is £75. This would be deducted from the cost of treatment, if treatment was deemed appropriate. The standard treatment cost for this procedure at BrightNewMe is £195.
Myokymia is a common condition of eyelid twitching. It normally occurs in healthy individuals who experience intermittent “quivering”, usually in one of the lower eyelids, for a few minutes, hours or sometimes even longer. It can occur in association with stress, fatigue, excess screen use or excessive caffeine/alcohol intake. Although a source of concern, twitching of this nature, in the absence of visual disturbance, is almost always benign (namely not associated with a neurological disorder).
If symptoms persist, or if there is twitching of other facial muscles, or if vision is affected, it would be important to see your GP for an examination. Persistent benign myokymia can be treated at BrightNewMe using Botox® to relax the muscle, and this often provides complete relief. Please note that this use of Botox® is off license, and you will need to have a full consultation to discuss the treatment in advance, the cost of which (for the consultation) is £75. This would be deducted from the cost of treatment, if treatment was deemed appropriate. The cost of the treatment itself is £175 for the first treatment, and £125 for further treatments.