Generally it looks like the sufferer is deliberately closing their eyes tightly. Also known as essential blepharospasm this condition often begins with eyelid twitching (myokymia) at a younger age and then progresses into this more severe form. It is a chronic bilateral and variably progressive dysfunction of the nerve that controls the muscles around the eye. It manifests as an uncontrollable forceful closure of the eyelids – generally it looks like the sufferer is deliberately closing their eyes tightly. Usually it affects both eyes at once but it is possible that only one eye is impaired. In some cases other muscles in the face can twitch as well especially around the cheeks and brow.
Early symptoms of the condition include occasional involuntary winking blinking or squinting of one or both eyes an increasing difficulty in keeping your eyes open and extreme sensitivity to light. As it progresses eyelid spasms increase in frequency and severity until they are unremitting leaving both eyelids clamped shut and the eyebrows pulled down. The effects are often made worse by stress fatigue bright lights watching TV driving or social situations. Severe cases can cause the eyelids to be forcibly closed for a duration longer than the typical blink reflex causing an erratic interruption in visual ability.
The cause of this condition is unknown though studies indicate the basal ganglia area of the brain may be involved. People in their 50s and 60s are the most susceptible and women are three times more likely to get it than men. Estimates of affected individuals in North America range up to about 150 000.
Although so far there is no known cure there are some treatments that reduce the severity of symptoms. Medications are helpful in only a small percentage of cases. A more effective treatment is the injection of Botox into the muscles of the eyelids. A down side to this treatment is that the injections need to be redone every few months. If you are not helped by either medication or Botox a surgical procedure can remove some of the muscle and/or nerves to those muscles that squeeze the lids shut.
Both the injections and the surgery are meant to paralyze the lid muscles and help alleviate the spasm but they can result in unpleasant side effects like paralysis of other facial muscles. This may lead to drooping of the corner of the mouth drooling or excessive tearing. Fortunately these side effects are usually temporary. Other treatments being used include biofeedback acupuncture hypnosis chiropractic therapy and nutritional approaches (though it is uncertain how effective these are).
Dark glasses though not a real treatment can reduce the intensity of sunlight; they can also serve another purpose for those who are self-conscious about their eye spasms. Stress management therapy can also be beneficial since stress is a common cause of eye spasms. Ongoing research is currently being conducted to find better treatment.