Tears naturally cleanse the cornea and neutralize any harmful microorganisms that may colonize in the eye causing infections. However, in some cases, the act of open and close the eyes can characterize an illness, the blepharoespasm. The main characteristic of blepharoespasm is the excessive and uncontrollable eyelid closure.The benign essential blepharospasm is characterized by progressive involuntary spasms of orbicular oculi muscle and other muscles in the upper region of the face (corrugador and procerus). The forced and chronicle contractions of perioculares muscles weaken the patient and promote functional and cosmetics eyelids alterations. Its treatment included a range of modalities and oral drugs with limited efficacy. Injections of botulinum toxin have been used, to induce localized, partial paralysis and has presented good temporary results, while periocular myectomy has shown good results in longer term. With the illness progress, the patient becomes remote of the social life. The frustration and the depression lead some to consider this illness as psychosomatic. However, the blepharoespasm severety probably is the causes and not the result of the psychological alterations.


The Botulin toxin-A is a neurotoxin that causes chemical denervation of the neuromuscular junction. The injection of the botulinum toxin offers an efficient therapy for muscular spasms control. After the injections, the action is observed into 48 and 72 hours and the duration of its symptomatic relief is about 8-24 weeks. Functionally impaired patients with blepharospasm who have not tolerated or responded well to medication or botulinum toxin are candidates for surgical therapy.


The surgery is performed under local anesthesia with sedaction. The upper and lower orbicularis, the procerus and the corrugador eyebrow muscles are removed. In elevated number of cases, the myectomy has improved the visual disability. Sometimes that procedure should be repeated. Complications of this surgery are the persistence of the blepharoespasm, hematoma, chronic lymphedema in the periorbital region (swelling) and anesthetize of the frontal region.