Benign Essential Blepharospasm

Benign essential blepharospasm (BEB) is a condition in which the muscles of the eyelids have involuntary (you cannot control them) contractions and spasms. In this condition, the eyes seem to be winking or even seem to be forced shut. There may be twitching of the eyelids that lasts for a long period of time.

BEB tends to occur while you are awake. The disorder may get worse, to the point that the eyes are closed for long periods of time. Although this interferes with vision, it is not a form of blindness, because the eyes themselves are not abnormal and are capable of seeing. You are simply unable to see through the closed lids.

BEB seems to occur most commonly in middle aged and elderly women.

BEB is different from occasional twitching of the eyelids, which happens to many people. Occasional twitching is called "benign fasciculation," and it has no lasting effect. It goes away within a few hours or days.

SYMPTOMS

BEB usually starts slowly. At first, you may:

  • Be blinking a lot.

  • Have a feeling of irritation in your eyes.

  • Notice your eyelids twitching a lot.

  • Be squinting more than usual; especially in bright light.

As time goes on, you may have difficulty keeping your eyes open. In general, symptoms occur while you are awake and go away while you sleep. As time goes on, all of the symptoms seem to get worse and more intense.

TREATMENT

Most commonly, BEB is treated with injections of botulinum toxin (Botox). Botox relaxes the muscles, stopping the twitching. Treatment may cause drooping eyelids, blurring of vision, dry eyes, or double vision, but these symptoms are usually temporary.