Blepharospasm

Involuntary, sustained and forceful closure of eyelids.

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Etiology

1. Essential (spontaneous) blepharospasm
   • Rare, idiopathic
   • 45-65 years
2. Reflex blepharospasm
   • Reflex sensory stimulation through branches of V^th Nerve
     • Phlyctenular keratitis
     • Interstitial keratitis
     • Corneal foreign body
     • Corneal ulcers
     • Iridocyclitis

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Presentation

• Persistent epiphora
• Edema of lids
• Spastic entropion (elderly)
• Spastic ectropion (children & young adults)
• Blepharophimosis

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Management

• Essential Blepharospasm
  • Botulinum toxin
    • SC, over orbicularis muscle
    • Blocks NM-junction, relieves spasm
  • Facial denervation
• Reflex Blepharospasm
  • Causative disease
  • Associated complications