Eyelid Movement Conditions & Eyelid Spasms

See the expert for eyelid movement conditions in Nashville, TN.

Restoring Healthy Eyelid Function

Oculoplastic surgeons were the first to treat ocular movement disorders and eyelid spasm conditions such as blepharospasm and hemifacial spasm. Dr. Sherman has extensive experience with BOTOX, the first treatment, as she has been injecting it for over 20 years since its FDA approval in 1989.

Why Choose Sherman Aesthetic Center?

Sherman Aesthetic Center founder Dr. Deborah Sherman is a national and international trainer for BOTOX and has taught her master injector techniques extensively with other physicians in the US, as well as Russia and China. She has also been injecting Xeomin since its FDA approval in 2011. This level of experience and expertise in the injection technique makes Dr. Sherman a well-qualified specialist with the highest level of training in treating blepharospasm and hemifacial spasm. Dr. Sherman and Dr. Mark Melson of Sherman Aesthetic Center specialize in many different types of operations to help the rehabilitation of patients with facial nerve palsy. As board-certified ophthalmologists and fellowship-trained eye plastic surgeons, Dr. Sherman and Dr. Melson can evaluate and advise you on all available treatment options to reduce eyelid spasms and restore healthy eyelid movement and function.

Blepharospasm

Blepharospasm (blef′ă-rō-spazm′) is the medical term for involuntary eyelid spasms or uncontrollable blinking around the eyes. In blepharospasm, also called benign essential blepharospasm (BEB), eyelid spasms can become so severe that one becomes debilitated from an inability to open the eyes well enough to see. As the condition progresses, the spasms may intensify, forcing the eyelids to remain closed for long periods of time and thereby causing functional blindness. It is important to note that blindness is caused solely by the uncontrollable closing of the eyelids and not by a dysfunction of the eyes. BEB occurs in both men and women, although it is especially common in middle-aged and older women. In approximately two-thirds of patients with blepharospasm, the condition develops after 50 years of age, and women are affected twice more often than men. The prevalence of essential blepharospasm is estimated to be five per 100,000. Factors that may exacerbate blepharospasm include reading, talking, bright light, stress, and driving.

Hemifacial spasm

Hemifacial spasm is the medical term for abnormal twitching and spasms of one side of the upper and lower face. It can cause the eye on the affected side to have functional blindness and inability to see due to the constant closure of the eyelids on that side of the face.

Is There a Treatment?

In most cases of blepharospasm and hemifacial spasm, the treatment of choice is botulinum toxin injections. There are several formulas; the most commonly used is BOTOX. Recently, a new formulation of botulinum toxin called Xeomin has been introduced. Xeomin is a newly FDA-approved botulinum toxin in the US; however, Xeomin has been used in Europe for years. Both BOTOX and Xeomin are formulas of botulinum toxins (neuromodulators) that are purified proteins that relax the muscles and stop the spasms. With over 20 years of experience with neuromodulators, Dr. Sherman and Dr. Melson bring a level of expertise in the injection technique that makes them well-qualified specialists with the highest level of training in treating blepharospasm and hemifacial spasm.

Hemifacial Spasm Before & After Photos

View Hemifacial Spasm Gallery

What Is the Prognosis?

With botulinum toxin treatment given with Dr. Sherman’s master injector technique, most individuals with blepharospasm and hemifacial spasm have substantial relief of symptoms. As with any medical treatment, side effects can occur.

Dr. Sherman, Dr. Melson, and their staff will thoroughly evaluate your symptoms and findings to see if you are more prone to any side effects of botulinum toxin therapies. Because the treatment effects wear off with time, almost all of the potential side effects are temporary.

What Are Other Treatment Options?

There are many medications (drug therapy) or surgery that have some limitations that you can discuss at the time of your consultation. In a tiny minority of patients in whom botulinum toxin injections are not tolerated, surgery may be necessary. Many medications of different classes have been tried unsuccessfully for the treatment of essential blepharospasm, including benzodiazepines (e.g., clonazepam), anticholinergics (e.g., trihexyphenidyl HCl; benztropine), and GABAergics (e.g., baclofen). Generally, with these medications, significant adverse effects occur before blepharospasm is reduced.

Incomplete Eyelid Closure or Lagophthalmos

Lagophthalmos (lag′of-thal′mŏs) refers to the condition in which an eyelid does not close completely. The lid may appear normal when open, but the problem occurs when attempting to close the lid. When the eyelid does not adequately close, the cornea is exposed to the air, and the eye surface dries out. Drying of the eye, in turn, leads to light sensitivity, tearing, and irritation. In more severe cases, scarring and infection of the front surface of the eye or cornea can develop.

Facial Nerve Palsy

The facial nerve is a nerve that supplies the muscles of the facial expression and the tear gland of the eye. The term Bell’s palsy describes a sudden weakness of the facial muscles due to paralysis of the facial nerve. Facial nerve palsy is a wider term describing weakness of the face due to loss of function of the facial nerve.

The causes of facial nerve palsy are numerous and include tumors, strokes, infections, trauma, and surgery. The vast majority of facial nerve palsies are sudden, self-resolving, and without apparent cause, which is the case with Bell’s palsy. However, loss of function of the facial nerve can have quite marked consequences on the face.

Challenges of Facial Nerve Dysfunction

Problems that can arise as a result of losing facial nerve function include:

Lagophthalmos: The inability to close the eye due to paralysis of the muscles of the upper and/or lower lid
Ectropion: An out-turning eyelid due to paralysis of the lower lid
Corneal exposure: Ulcers of the corneal surface due to inadequate moisture
Brow ptosis: Drooping of the eyebrow due to paralysis of the forehead muscles
Midface/cheek ptosis: Drooping descended cheek due to paralysis of the cheek muscles
Spasms: Abnormal spasms of the facial muscles due to abnormal healing of the damaged nerve
Crocodile tears: Excess tear production which occurs when chewing

Surgical Rehabilitation

Oculoplastic surgeons such as Dr. Sherman and Dr. Melson specialize in many different types of operations to help rehabilitate patients with facial nerve palsy. Because they are board-certified ophthalmologists and have been fellowship trained in plastic surgery around the eye, the surgeons at Sherman Aesthetic Center can carefully evaluate the lid and corneal function with a bio-microscope in order to customize the treatment plan. Each patient needs to be treated on an individual basis. Patients with facial nerve palsy will have different clinical features with varying severity of problems. If you would like to be evaluated for treatment for eyelid movement conditions and eyelid spasms, schedule a personal consultation in Nashville today!