St. Petersburg & Clearwater Blepharospasm

Blepharospasm is an involuntary squeezing of the eyelids.

Although the first records of blepharospasm date back to the 16th century, it was not until the late 20th century that physicians recognized that this debilitating movement disorder was truly of neurologic origin. Before this, physicians assumed that this was a psychiatric problem.

In its early stages, blepharospasm is usually misunderstood by the afflicted patient and his/her family and even may be misdiagnosed once the patient consults a physician. The disorder begins with frequent blinking, and patients may complain of their eyes being sensitive to light, feeling dry, and feeling like there is something in them. These symptoms progress over a variable period to include involuntary unilateral spasms, which later usually involve both sides of the face. Patients may report that they are disabled to the point where they have stopped watching television, reading, driving, and/or walking. A family history positive for dystonia or blepharospasm further aids in the diagnosis.

Blepharospasm usually involves both sides of the face but a related condition, hemifacial spasm, involves only one side. Most of the time, blepharospasm occurs by itself and doctors cannot find any other nerve or brain problem.

Blepharospasm can result in prolonged eyelid closure and severe visual disability. It can also be very emotionally upsetting to the patient when the contractions occur in social settings and cannot be controlled.


Treatment

Blepharospasm is a chronic condition, which too often progressively worsens. Although no cure currently exists, patients have excellent treatment options. Since the disease frequently progresses despite treatment, patients may become frustrated and resort to unconventional remedies, sometimes becoming the victims of charlatans.

The first line of treatment for all patients should address the sensory limb or the eye-related causes which may contribute to the blepharospasm vicious cycle. Such measures include wearing tinted sunglasses with ultraviolet blocking to decrease the poorly understood cause of painful light sensitivity (photo-oculodynia). Lid hygiene to decrease irritation and blepharitis (inflammation of the eyelids) should be encouraged. Frequent applications of artificial tears and sometimes even occluding the tear drainage system (punctal occlusion) to alleviate dry eyes often improve symptoms.

Fortunately, there now is an answer to this common problem. An injection, performed in minutes in the office by a trained medical specialist, may result in complete reversal of symptoms. Patients are usually well satisfied with this treatment, which is covered by most insurance plans and by Medicare.

Botulinum A toxin, or Botox, is regarded as the most effective treatment of choice for the rapid but temporary treatment of orbicularis spasm. More than 95% of patients with blepharospasm report significant improvement with use of the toxin. Although Botulinum A toxin is the product of the bacteria and once was the cause of botulinism, its use for the treatment of blepharospasm is perfectly safe and is highly effective.

Although Botox is now widely known and used as a wrinkle treatment, it was originally developed to treat blepharospasm and related dystonias (movement disorders) in the late 1980’s. Before this, the treatment of these debilitating disorders were usually disappointing and ineffective. Therefore, the development of Botox represented a truly giant leap forward by modern medicine.

Unlike the use of Botox for wrinkle treatment, its use for the treatment of blepharospasm and related diseases, are usually covered by your medical insurance.

What to Expect with Blepharospasm Surgery and Treatment

Many patients tell us that understanding the treatment journey helps ease their concerns. Typically, your first visit at Tampa Bay Cosmetic Surgery Center in will include a thorough evaluation by our trusted, board-certified specialists. We’ll discuss your symptoms, medical history, and family background to confirm the diagnosis.

You might notice that initial treatments focus on managing symptoms conservatively — like using tinted sunglasses or artificial tears to reduce irritation. If Botulinum A toxin injections (commonly known as Botox) are recommended, these quick in-office procedures are generally well tolerated and provide significant relief, often within days.

Because blepharospasm is a chronic condition, ongoing follow-up is important. Our caring team will work closely with you to adjust treatment plans, monitor progress, and address any concerns. Most patients experience improved quality of life, including easier social interactions and greater independence in daily activities.

If surgery is considered for severe or refractory cases, we’ll explain the procedure in detail, including potential risks and expected recovery time. Our hands-on approach means you’re never alone — we’re here to support you at every step.

FAQs

What is blepharospasm and what causes it?

Blepharospasm is an involuntary contraction or squeezing of the eyelids caused by neurological dysfunction. It is a movement disorder that can severely affect quality of life, but the exact cause remains unclear.

How is blepharospasm diagnosed?

Diagnosis usually involves a detailed medical history, symptom evaluation, family history of dystonia or blepharospasm, and a thorough eye and neurological exam by a trusted, board-certified specialist.

What treatments are available for blepharospasm?

Treatment options include conservative measures like tinted sunglasses, artificial tears, and lid hygiene to manage eye irritation. The most effective treatment is Botulinum A toxin (Botox) injections, which provide temporary relief from eyelid spasms.

Is blepharospasm surgery a common treatment?

Surgery is generally reserved for severe or refractory cases that do not respond to Botox injections and other conservative treatments. Your caring specialist will discuss risks, benefits, and recovery in detail if surgery is considered.

Will insurance cover Botox treatment for blepharospasm?

Unlike Botox used for cosmetic purposes, Botox injections for blepharospasm are usually covered by most medical insurance plans, including Medicare.