Eye twitching, a prevalent occurrence, involves the involuntary twitching of the muscles around one eye, leading to occasional blinking. This condition, scientifically termed orbicularis myokymia, is often attributed to factors such as insufficient sleep, excessive caffeine intake, or stress. While it can be quite bothersome, the good news is that eye twitching is typically not associated with long-term vision or health issues. For cases of mild and occasional twitching, especially when limited to one side, recommended strategies include reducing caffeine intake and ensuring adequate sleep. By addressing these factors, one can often observe the resolution of the twitching. In instances of persistent symptoms, a low dose of Botox injections may be a viable treatment option. Seeking professional advice from Dr. Kian Eftekhari can help determine the most suitable approach for effective management. Remember, while eye twitching can be irritating, it is generally a manageable condition without significant long-term consequences.
Eye Twitching versus Blepharospasm
Some patients experience a more serious condition known as blepharospasm, characterized by involuntary eyelid spasms that lead to excessive blinking. Blepharospasm involves abnormal contractions of the eye muscles and falls under the category of focal dystonia. While patients with blepharospasm maintain normal vision, the persistent disturbance can interfere with visual perception and, in severe cases, result in functional blindness. This means that although the eyes function correctly when open, they remain shut for extended periods during daily activities such as reading or driving.
Dr. Eftekhari is Recognized for Blepharospasm Research
Board-certified and highly experienced, Dr. Eftekhari is renowned for effectively treating blepharospasm through both medical interventions and surgical procedures. His commitment to advancing knowledge in this area is evident through his published academic research, addressing the urgent need for improved treatments for patients with blepharospasm.
Causes of Blepharospasm
Understanding the root cause of eye twitching in blepharospasm remains elusive. Dr. Eftekhari explains to patients that there is a mismatch between the eye and the brain. Ordinarily, the eyelid twitches in response to external stimuli such as wind or dust, triggering a signal from the eye’s surface to the basal ganglia, the deepest part of the brain. The brain then sends a signal back to the eyelids, prompting them to blink. This process is intentional, ensuring involuntary blinking in response to environmental factors.
In blepharospasm patients, this signaling system is disrupted, leading to an overly strong signal from the brain when the eye perceives minor stimuli like dust or wind. This malfunction results in excessive eye twitching and blinking, with severe cases leading to the inability to open the eyes, known as apraxia of eyelid opening—a serious manifestation of this condition.
Benign Essential Blepharospasm and Parkinson’s Disease
While some cases show a genetic link to blepharospasm with a family history, research indicates no clear connection between benign essential blepharospasm and Parkinson’s disease. Occasionally, individuals with existing Parkinson’s may experience eyelid twitching. In essence, having blepharospasm does not imply a predisposition to Parkinson’s disease.
Symptoms of Blepharospasm
Blepharospasm typically initiates with excessive eye twitching, blinking, and irritation, exacerbated by stressors like bright lights, fatigue, or emotional distress. Progressing symptoms occur more frequently and may interfere with daily activities. Notably, blepharospasm symptoms do not manifest during sleep, and patients may experience relief upon waking. In advanced stages, prolonged eye closure may be observed.
At times, blepharospasm can extend to the mouth and jaw, manifesting as oromandibular dystonia, where patients involuntarily grimace, clench their jaw, and protrude their tongue. When combined with blepharospasm, this condition is termed Meige syndrome. Patients may also experience heightened sensitivity to bright light and dry eyes.
Diagnosis of Blepharospasm
Diagnosing blepharospasm does not involve specific tests, and laboratory results in affected individuals are typically normal. The diagnosis relies on a combination of patient history, physical examination, and neurological evaluation. This medical assessment helps differentiate blepharospasm from other eyelid conditions, such as infection, allergy, or disorders causing muscular weakness or contractions.
Treatment of Blepharospasm
Blepharospasm-related eye twitching can significantly impact a patient’s quality of life. Fortunately, ophthalmologists in San Francisco discovered an effective treatment in the early 1980s—botulinum toxin, commonly known as Botox. Dr. Eftekhari, with extensive experience in administering Botox injections, has performed thousands of these procedures to manage blepharospasm. Most patients receive injections every three months to maintain symptom relief.
For individuals not fully responsive to Botox, alternative medical treatments such as methylphenidate (Ritalin) or benzodiazepines (Valium) may be prescribed. In severe cases with the manifestation of apraxia of eyelid opening, Dr. Eftekhari offers the myectomy surgery, a meticulous procedure where every visible fiber of the upper eyelid muscle causing spasms is carefully removed. As one of the select few globally trained in orbicularis oculi myectomy surgery, Dr. Eftekhari has successfully performed numerous procedures to address severe blepharospasm symptoms.
Frequently Asked Questions about Blepharospasm
Blepharospasm is a condition characterized by abnormal contractions of the eye muscles, leading to involuntary spasms and excessive blinking. It falls under the category of focal dystonia, specifically affecting the eyelids.
Patients with blepharospasm may experience significant interference with daily activities, such as reading or driving, due to involuntary eye closures. In severe cases, prolonged spasms can result in functional blindness.
Generally, blepharospasm is not associated with long-term vision or health issues. While it can be bothersome, it is manageable with appropriate treatments.
The exact cause of blepharospasm is not fully understood. It involves a mismatch between the signals sent by the eye and the brain, leading to excessive twitching and blinking. Stress factors, bright lights, fatigue, or emotional distress can trigger symptoms.
Diagnosis involves a comprehensive evaluation, including patient history, physical examination, and neurological assessment. Currently, there is no specific test for blepharospasm, and laboratory results are typically normal.
The primary treatment for blepharospasm is the use of botulinum toxin (BoTox) injections, which temporarily weaken the muscles causing spasms.
Other medical treatments, such as methylphenidate (Ritalin) or benzodiazepines (Valium), may be prescribed. In severe cases, surgical options like the myectomy surgery may be considered.
Contact Us for Your Personalized Consultation
If you are experiencing eye twitching or spasms, contact our office to schedule an evaluation with Dr. Eftekhari. Seeking professional advice ensures a thorough assessment and personalized treatment plan for effective management of your condition.