Benign essential blepharospasm (eyelid spasm) is a rare condition that causes increased blinking, involuntary spasms of the muscles surrounding the eyes, and an intermittent inability to open the eyes. The condition usually starts with twitching and progresses to severe spasms. Patients with this condition may eventually be unable to read, drive, or perform normal daily activities because they cannot open their eyes sufficiently.
The treatment of choice for benign essential blepharospasm is periodic injections of Botox®. Botox® is a powerful drug that blocks the connection between nerves and facial muscles. It is injected in strategic locations in the eyelids and forehead. Botox® can significantly reduce or resolve spasms, but it works temporarily and must be repeated about every three to four months.
Some patients may not have an adequate response to Botox® or have a diminishing response over time. If this is the case, and the spasms continue to cause a significant disruption, surgical myectomy may be an option. This treatment consists of excising some or all of the orbicularis oculi muscle in the upper eyelids, the muscle that causes the eyelids to close. This procedure has been shown to significantly improve blepharospasms. The risks include incomplete eyelid closure and postoperative bruising and swelling.
If there is any drooping of the upper eyelids or excess upper eyelid skin, ptosis repair or upper eyelid blepharoplasty may help improve visual clarity. These procedures may also be performed along with a partial surgical myectomy.
Recovery from BLEPHAROSPASM Treatment
Most patients only experience mild discomfort after bleparospasm treatment and can resume normal daily activities the next day. After Botox® injections, we recommend both avoiding exercise for the rest of the day and laying down for the four hours following the treatment, as this may result in migration of the Botox® to cause ptosis. Tylenol is recommended to ease the discomfort, which should within a day.
Dr. Kashyap will see you for a two week follow-up visit to reevaluate if the treatment was adequate or if a booster is necessary.
It is safe to resume wearing eye makeup and contact lenses the same day.
Arnica and Bromelain are recommended to take prior as well as after surgery to minimize the bruising and swelling of the face.
Minor swelling and bruising generally resolve within one to two weeks of surgery. Cold compresses can help you through the healing period, and we may prescribe antibiotic ointment and eye drops.
Cold compresses can help you through the healing period, and we may prescribe antibiotic ointment and/or eye drops.
Dr. Kashyap will see you for follow-up visits and will remove your sutures seven to 10 days after your procedure. Please avoid heavy lifting and strenuous exercise for two weeks.
Dr. Kashyap will let you know when it is safe for you to resume wearing eye makeup and contact lenses, usually within one to two weeks.
If you experience dry eye after surgery, we will recommend artificial tears to keep your eyes lubricated.