How is benign essential blepharospasm (BEB) treated?

Updated: May 20, 2019
  • Author: Robert H Graham, MD; Chief Editor: Edsel Ing, MD, MPH, FRCSC  more...
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Blepharospasm is a chronic condition, which too often progressively worsens. Although no cure currently exists, patients have excellent treatment options. Since the disease frequently progresses despite treatment, patients may become frustrated and resort to unconventional remedies, sometimes becoming the victims of charlatans. [13]

The most effective of today's conventional treatments include botulinum toxin injections, education, and support provided by the Benign Essential Blepharospasm Research Foundation (BEBRF), pharmacotherapy, and surgical intervention. Unconventional treatments have included faith healing, herbal remedies, hypnosis, and acupuncture.

The first line of treatment for all patients should address the sensory limb of the blepharospasm vicious cycle circuit. Such measures include wearing tinted sunglasses with ultraviolet blocking to decrease the poorly understood cause of painful light sensitivity (photo-oculodynia). [34] Adams et al (2006) showed improved light sensitivity with gray and FL-41 tinted lenses, [35] and Blackburn et al (2009) showed the FL-41 tint improves blink frequency, light sensitivity, and functional limitations in patients with benign essential blepharospasm [36] .

Taping up the eyelids and ptosis crutches may be tried but are often not tolerated as a long-term treatment. Lid hygiene to decrease irritation and blepharitis should be encouraged. Frequent applications of artificial tears and punctal occlusion to alleviate dry eyes often improve symptoms.

Benign Essential Blepharospasm Research Foundation, formed in 1981, is a foundation established to undertake, promote, develop, and search for a cure for benign essential blepharospasm (BEB), Meige syndrome, and related disorders. This organization is located in Beaumont, Texas, and promotes awareness of these conditions to both physicians and the general public, organizes support groups throughout the world, and obtains funding for research and education. [37, 38, 39]

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