Blepharospasm describes a condition where a person experiences an involuntary spasm of the muscles surrounding the eyelid. “Blepharo” refers to the eyelids, while “spasm” describes twitching of the muscles.

Eyelid spasms refer to when an eyelid twitches or suddenly closes. These movements are involuntary, meaning they are out of a person’s control. This differs from blinking or winking, which a person typically controls and does willingly.

A blepharospasm may last a few seconds or as long as a few hours. The spasm may range from blinking to scrunching up the whole face. In more advanced stages, it may cause a person to close their eyelids so tightly they cannot see.

A close-up of a person's eye-2.Share on Pinterest
Pawel Wewiorski/Getty Images

Also known as benign essential blepharospasm (BEB)Trusted Source, blepharospasm is a neurological disorder that causes twitching, or spasms, of the eyelid. Specifically, it describes when one or both of the eyelids close involuntarily. BEB may last for a few seconds to a few hours. When it first starts, a person may blink, wink, or pinch up their face.

BEB is a type of dystonia. This describes a group of neurological conditions that cause jerky movements or muscle spasms.

Vs. hemifacial spasms

A hemifacial spasm is a similar condition that causes spasms around the eye. It occurs when facial muscles constrict, or tighten up. However, it only affects one side of the face and usually involves other muscles, such as the cheek or mouth.

Vs. myokymia

Myokymia describes eyelid twitching that may occur due to sleep deprivation or stress. These involuntary twitches only occur during periods of stress or inadequate sleep and typically resolve with rest or a reduction in stress.

Currently, the exact cause of BEB is unknown. However, researchers believe it is likely multifactorial, involving the interaction of certain genes and environmental factors.

Health experts also note that BEB likely develops when the part of the brain that controls the eyelid muscles stops working correctlyTrusted Source. Specifically, this refers to the basal ganglia, which is the part of the brain responsible for regulating motor and learning functions.

However, some evidence links BEB to motor network disorders, such as Parkinson’s disease. These conditions can also cause involuntary or uncontrollable body actions. Other research also notes that neurotransmitter imbalances, such as inhibiting the function of dopamine, may also play a role in the development of BEB.

Additionally, some possible risk factors for BEB may include:

  • a family history of BEB
  • a history of eye problems, such as eye trauma
  • the use of certain drugs to treat Parkinson’s disease
  • being a female between the ages of 40 and 60 years

Other health conditions may also increase the risk of BEB. These may include:

The characteristic featureTrusted Source of BEB is the involuntary contractions of the orbicularis oculi muscleTrusted Source. This refers to the muscle surrounding the eye socket and is responsible for closing the eyelids and other facial expressions. A 2022 systematic review adds that other common symptoms include excessive blinking and eyelid fluttering.

  • blinking more often than usual
  • difficulty keeping eyelids open, which can affect vision
  • eye irritation
  • light sensitivity

At present, there is no specific test to make a definitive diagnosis of BEB. Typically, a doctor will be able to make a diagnosis following a comprehensive eye examTrusted Source. During the exam, the healthcare professional will also identify characteristic symptoms and ask questions about a person’s individual and family medical history.

The main treatment for BEB is typically Botulinum toxin (botox) injections. This is a muscle-relaxing substance that blocks the signals sent from the nerves to the muscles.

A doctor will administer the injections into the muscles above and below the eye. The injections usually take a day or two to work and may last up to 3 months. As the effect is temporary, a person will typically require repeat injections to control the excessive muscle contractions.

If injections are not suitable, a doctor may recommend medications or surgery instead.

Some people may experience relief from BEB using the following drugs:

  • clonazepam
  • trihexyphenidyl
  • lorazepam
  • baclofen
  • tetrabenazine

However, as side effects are common with these medications, doctors do not frequently recommend them.

Two types of surgery are often suitable to help treat BEB. One type involves removing the facial muscle responsible for the spasms. The other removes a portion of the nerve to make the spasms less severe.

Blepharospasm, also known as benign essential blepharospasm, refers to involuntary twitching of the eyelids. Researchers are unsure of the exact cause, but it likely occurs due to a combination of genetic and environmental factors affecting the part of the brain that controls movement.

A doctor will typically diagnose blepharospasm following a routine eye exam. Treatment options include botox injections, certain drugs, and surgery.