What is Blepharospasm?
Blepharospasm is a neurological condition characterized by
abnormal contraction of the eyelid muscles. It is a bilateral condition and a
type of focal dystonia in which a person experiences episodic closure of
eyelids. The exact cause of blepharospasm is not known yet, and it is not even
associated with another disease or syndrome. Initial symptoms include mild and
infrequent muscle spasms that progressively worsen leading to forceful and
frequent contractures of eyelids. In later stages, benign essential
blepharospasm may also cause functional blindness, as the person becomes unable
to temporarily open the eyes.
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Fortunately, there are excellent treatment options available to
help alleviate symptoms of BEB. Botox or botulinum toxin Type A has been a
generally accepted standard of care for blepharospasm since getting approval
from the US Food and Drug Association (FDA) in 1989. These injections are a
well-established treatment for blepharospasm. Most of people know Botox for its
cosmetic applications, but only a few know that it was first used to treat eye
muscle problems and the cosmetic applications came to fore only as the side
effects of Botox treatment.
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How is the procedure performed?
Botox treatment involves injecting a highly diluted form of
botulinum toxin in prescribed doses directly into the affected eye muscles. The
toxin is administered into the orbicularis oculi muscles every three to four
months. The dosage varies from 2 to 5 units per injection site and each eye is
divided into 4 to 8 sites. The drug sticks itself to the nerve terminals at the
receptor sites, inhibiting the release of vesicular acetylcholine from the
terminals. This causes temporary paralysis of the associated muscles. Average
onset of effects is in 2 to 3 days and average peak effect may be seen 7 to 10
days after the injection. Subsequent treatment is determined based on the
patient's response. Most patients need re-treatment every three months to four
months and progressively larger doses may be required over a long period of
time
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Is this treatment painful?
Since the area around eyes is very sensitive, local anesthesia
is given to the patient before performing the procedure to numb the area. To
further minimize the discomfort associated with the procedure, hair thin
sterile needles imported from the United States are used.
What are the risks associated with Botox treatment?
Botox injections are generally safe and rarely cause any side
effects. However, getting the injection from an inexperienced doctor may cause
side effects including,
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- Dry eyes or
mouth
- Droopy eyelid
- Headache or neck
pain
- Difficulty in
breathing and/or swallowing
