Condition: Blepharospasm 2017-10-12T10:24:21+00:00

Blepharospasm Overview

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The best way to figure out whether your specific condition can be treated or not is to give us a call. We can answer any questions you have and help you clarify which treatment options might be suitable for you.

There are different treatment options available for this condition and the most common ones are listed below:

Learn more about treatment options

Blepharospasm

What is a Blepharospasm?

Blepharospasm and hemifacial spasm are neurological conditions that affect the facial muscles. Blepharospasm affects the muscle around both eyes (orbicularis muscle), whilst a hemifacial spasm affects more muscles in one side of the face (eye, cheek, mouth, etc).

Causes of Blepharospasm

The cause of these diseases remains largely unknown. Patients with facial palsy may develop a form of blepharospasm when the nerve tries to grow back, known specifically as an ‘aberrant regeneration of the facial nerve’.
There are a small number of non-neurological causes of blepharospasm including severe dry eye, spastic entropion (eyelashes turning in towards eye) and severe photosensitivity.

With blepharospasm and hemifacial spasm, the appearance of the face also changes and social interactions are affected.

Symptoms for Blepharospasm

The symptoms of both belpharospasms, hemifacial spasms and aberrant regeneration spasms are related to the involuntary contractions of the muscles affected. These contractions can be very frequent or episodic. If the contractions affect the muscles around the eyes, discomfort, watery eyes, an inability to properly open the eyes or impeded vision may occur. If the muscles around the mouth are affected it may not be possible to eat or speak properly. Sometimes the contractions are painful.

Examination for Blepharospasm

A thorough ophthalmic examination is carried out to ensure that there are no eyelid or eye surface problems. The oculoplastic surgeon takes photographs and videos to document the face and eyelid movements. Sometimes a neurological examination and neuroimaging scans (CT-scan/MRI) are requested. Particular care is taken to observe which muscles are involved in the spasm so that a planning map of the face and peri-orbital area can be made for treatment with Botulinum Toxin A (e.g. Botox (r), Dysport (r), etc.).

Treatment for Blepharospasm

As the main problem in these conditions is muscle contraction, controlled paralysis of the muscles affected reduces the effects. This is done with Botulinum toxin A (Botox® or Dysport®) injected in small doses into the muscles with spasm. Great care is taken choosing the injection sites in order to minimise the risk of potential side effects. Blepharospasm can be treated effectively with Botulinum Toxin A injections every 3-4 months with only a few patients requiring surgery for ptosis or removal of orbicularis. In patients with hemi-facial spasm, care is taken when injecting close to the mouth in order to avoid drooling.

Before any injection of Botulinum Toxin A, it is advisable to take paracetamol to reduce the slight discomfort of the injections.

Ice packs are not required afterwards and you can go straight back to work.

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Well done and thank you! You saw me last November for my annual RP assessment. You recommended to see the Glaucoma unit which I duly attended last week. (There was a delay because I had a cataract op in February)I do indeed have glaucoma as well as RP. Thankfully glaucoma is likely to be treatable with drops, so now at last the deterioration in my sight may be least partially arrested. I hope you will recommend to the retinal team that all RP suffers are tested for Glaucoma at fitting intervals. Yours sincerely, Edmund S.”
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On behalf of my mother as well as myself, I would like to thank you for the consultation we had with you last Friday regarding my Usher Type 2/ RP condition. The knowledge and advice you shared with us was much appreciated. Today I received copy of the letter which you sent to my GP as record of the consultation. You might recall I mentioned that I have and indoor cycling frame which is great for an ex-road cyclist. If you should have any other patients who have to give up cycling on the road, I can recommend the “e-motion rollers” which is an American product and allows cyclists to ride their actual bike without modifications – suitable only for road bikes with high tyre pressure. Kind regards, Chris B.”
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“Dear Both,

Many thanks for taking care of my ptosis surgery today.
I am now back home and resting but wanted to send a quick note to thank you for taking such good care of me.

Many thanks, Charmaine”

Charmaine

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Frequently Asked Questions

Botulinum toxin A is injected in clinic during a routine visit. The injection is made with a tiny needle, very slowly and gently.

We often inject botulinum toxin A into different areas of the face and neck as well around the eyes.

Most patients say that they feel little or no pain during the injections. If you feel you are more pain sensitive you can take painkillers and tranquilising tablets prior to arriving at the clinic.

There is also the option to apply an anaesthetic cream to the face 30 minutes before undergoing the procedure. The oculoplastic surgeon will discuss the various options with you.

You will not need any treatment or special advice after this procedure. Ice packs may help if there is a small amount of bruising.

You will not need any treatment or special advice after this procedure. Ice packs may help if there is a small amount of bruising.

Typically there is a review a few weeks after the procedure to check the final result. Follow up after these procedures depends on the patient. The Botulinum toxin works for a limited period of time (2–4 months).

Spasms will gradually get worse again and regular injections will be necessary to prevent symptoms.