Blepharospasm

Last Updated October 2020 | This article was created by familydoctor.org editorial staff and reviewed by Peter Rippey, MD, CAQSM

What is blepharospasm?

Blepharospasm is a rare condition that causes your eyelid to blink or twitch. You can’t control it. This is called involuntary blinking or twitching. The twitching is caused by a muscle spasm around your eye.

Blepharospasm is just one of several reasons your eyes might twitch. More common reasons include minor things, such as being tired or high caffeine use. Serious reasons might include neurological diseases. Blepharospasm affects women more than men. It may run in families.

Symptoms of blepharospasm

Symptoms of blepharospasm include repeated, uncontrolled eye twitching or blinking. The twitching often happens during times you are overly tired, stressed, or anxious. It can also happen when you’re exposed to bright light and sunlight. It might get better when you’re sleeping or concentrating on a task.

The uncontrollable twitching can become worse over time. Eventually, you may feel as if it’s difficult to open your eyelids. As the condition progresses, your eyelids may be closed for several hours at a time. Spasms can develop in your face, as well.

What causes blepharospasm?

Blepharospasm is caused by abnormal brain function in the part of your brain that controls muscles. Doctors aren’t sure why this happens. Symptoms can be triggered by stress and being overly tired. Or they could be triggered by a neurological condition, including Tourette syndrome or Parkinson’s disease. Some medicines can make blepharospasm worse. Be sure to tell your doctor about any medicines you’re taking.

How is blepharospasm diagnosed?

Your doctor will examine your eye and ask about your symptoms. He or she will ask you about your medical history. If he or she suspects your eyelid twitching is caused by anything more than stress or being tired, you may be referred to a for a neurological exam. Such an exam might include imaging tests of your brain and eyes. These could include X-ray, magnetic resonance imaging (MRI), or computed tomography (CT) scans. These scans allow doctors to look inside your body.

Can blepharospasm be prevented or avoided?

Blepharospasm can’t be prevented or avoided.

Blepharospasm treatment

There is no cure for blepharospasm. But there are treatments to ease your symptoms.

  • Some injection-type medicines, such as botulinum toxin (brand name: Botox), can treat muscle conditions. These medicines temporarily weaken the muscles of the eyelids. The medicine is injected with a needle under the skin of the eyelid.
  • Some oral medicines may work, but only for a short period of time. Symptoms usually return.
  • A surgical procedure called a myectomy can treat symptoms. This surgery removes some of the muscles and nerves within the eyelid.

Treatments also may depend on the underlying cause of your blepharospasm. For example, medicines used to treat Parkinson’s disease may ease the eye twitch.

Some people use alternative treatments. These could include biofeedback, acupuncture, hypnosis, chiropractic care, and nutritional therapy. These haven’t been proven to be effective treatments.

Living with blepharospasm

Blepharospasm is a lifelong disorder. Talk to your doctor about how to ease your symptoms. Also, consider keeping a journal to track when the twitching occurs. You may notice it happens during exposure to bright lights, times of stress, or when you are overly tired. Knowing your triggers can help you avoid or reduce your symptoms.

Questions for your doctor

  • Is blepharospasm genetic?
  • Can blepharospasm be a sign of a brain tumor?
  • Can eye strain cause blepharospasm?
  • Which medicines cause blepharospasm?
  • Does blepharospasm get worse with age?
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