Eyes Squeezed Shut


Do you ever have a problem where your eyes want  to squeeze shut uncontrollably?   Do people accuse you or winking at them? Do you feel your lid twitching?

If you answered  yes to any of these you could be having blepharospasm.

What Are Blepharospasm

The eyelids have a muscle that goes around in a circle in both the upper and lower lids, called the orbicularis. This muscle is responsible for closing the eye. In patients with blepharospasm the muscle squeezes involuntarily.  This muscle over powers the muscle that opens the eyelid, the levator muscle, and causes the eye to shut.

 Causes of Blepharospasm

The spasms are caused by over stimulation of the muscle or the nerve that controls the muscle.  Sometimes this can be a tumor, trauma, dry eyes, or even an abnormality of a blood vessel. These are actually the rarer causes of blepharospasm. Most often there is no specific reason for the spasms, and this is called benign essential blepharospasm (BEB). This is a really fancy way of saying we do not know the true cause, yet it’s not due to a disease.

Treatment For Blepharospasm

30 years ago had you walked into your doctors office with blepharospasm the main treatment would have been sedating oral medications or surgery to remove the muscle, which was often very disfiguring. In the late 70s early 80s an ophthalmologist, Dr. Alan Scott, figured out that injecting botulinum toxin (Botox) into the muscle would temporally relieve the spasms.

Botox Preferred Treatment for Blepharospasm

And such Botox was created.  It was not until almost 12 years later that the use of Botox for cosmetcs was discovered.  Today injecting a botulium toxin (Botox/Xeomin/Myobloc)  for blepharospasm is still the preferred treatment.

 Botox Covered by Insurance

About 10 sticks per eye with a tiny needle is often all that is needed to reduce or eliminate the problem.   Treatment may be repeated in 3 months if needed. This is a medical problem and is paid for by most insurance plans.

If you or someone you know is suffering with blepharospasm call on of our neuro-ophthalmologsit at 941-921-5335 to get help.




Jody Abrams, MD, FACS
Sarasota Retina Institute
Sarasota, Florida 34239


  1. […] an ophthalmologist from California, Dr Scott, was looking for a way to help patients suffering from involuntary facial spasms and people with double vision. He figured out that with a purified version of botulinium toxin,  he […]