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Benign essential blepharospasm
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Condition

Benign essential blepharospasm

Benign essential blepharospasm is a type of dystonia characterized by involuntary, abnormal blinking or spasms of the eyelids, which can severely impair vision as it progresses.

Overview

Benign essential blepharospasm is a condition characterized by abnormal blinking or spasms of . This condition is a type of dystonia, which is a group of movement disorders that involve uncontrolled tensing of the muscles (muscle contractions), rhythmic shaking (tremors), and other involuntary movements. Benign essential blepharospasm is different from the common and temporary eyelid twitching that can be caused by fatigue, stress, or caffeine.

The signs and symptoms of benign essential blepharospasm usually appear in mid- to late adulthood and gradually worsen. The first signs and symptoms of the condition include an increased frequency of blinking; dry eyes; and eye irritation that is aggravated by wind, air pollution, sunlight, and other irritants. These signs and symptoms may begin in one eye, but they ultimately affect both eyes. As the condition progresses, spasms in the muscles that surround the eyes cause involuntary blinking or squinting. Over time, affected individuals find it increasingly difficult to keep their eyes open, which can severely impair their vision.

In some people with benign essential blepharospasm, the symptoms of dystonia spread beyond the eyes to affect other facial muscles. When people with benign essential blepharospasm also experience involuntary muscle spasms that affect the tongue and jaw (oromandibular dystonia), the combination of signs and symptoms is known as Meige syndrome.

Frequency

Benign essential blepharospasm affects an estimated 20,000 to 50,000 people in the United States. For unknown reasons, it occurs in women more than twice as often as it occurs in men.

Causes

The causes of benign essential blepharospasm are unknown, although the disorder is likely a result of a combination of genetic and environmental factors. Certain genetic changes probably increase the likelihood of developing this condition, and environmental factors may trigger the signs and symptoms in people who are at risk.

Studies suggest that this condition may be related to other forms of adult-onset dystonia, including uncontrolled twisting of the neck muscles (spasmodic torticollis) and spasms of the hand and finger muscles (writer's cramp). Researchers suspect that benign essential blepharospasm and similar forms of dystonia are caused by problems in the basal ganglia, which are structures deep within the brain that help start and control movement.

Although genetic factors are almost certainly involved in benign essential blepharospasm, no genes have been clearly associated with the condition. Several studies have suggested that common variations (polymorphisms) in the DRD5 and TOR1A genes increase a person's risk of developing benign essential blepharospasm. However, other studies have found no connection between changes in these genes and a person’s risk of this condition. Researchers are working to determine which genetic factors are related to this disorder.

Learn more about the genes associated with Benign essential blepharospasm

  • DRD5
  • TOR1A

Inheritance

Most cases of benign essential blepharospasm are sporadic, which means that the condition occurs in people with no history of this disorder or other forms of dystonia in their family.

Less commonly, benign essential blepharospasm has been found to run in families. In some of these families, the condition appears to have an autosomal dominant of inheritance, which means that one copy of an altered gene in each cell is sufficient to cause the disorder. However, researchers have not identified the genes that cause benign essential blepharospasm in these cases.

Other Names

  • Essential blepharospasm
  • Eyelid twitching
  • Primary blepharospasm
  • Spasm of eyelids

Frequently Asked Questions

Common eyelid twitching is usually temporary, mild, and often linked to stress, fatigue, or caffeine, affecting only one eye or a small part of the eyelid. Benign essential blepharospasm, however, typically involves both eyes, starts with increased blinking and eye irritation, gradually worsens over time, and progresses to involuntary, forceful spasms that make it difficult to keep the eyes open.
Yes, symptoms can be aggravated by bright lights, wind, air pollution, reading, driving, and stress. Wearing sunglasses, especially those with dark or tinted lenses, can help reduce light sensitivity. Avoiding irritants like smoke or strong winds, and managing stress through relaxation techniques, may also help reduce symptom severity.
Benign essential blepharospasm usually begins in mid- to late adulthood and gradually worsens over several years. While it primarily affects the eyelids, in some individuals, the involuntary muscle spasms can spread to other facial muscles, affecting the jaw, tongue, or neck. When it involves the tongue and jaw, along with the eyes, it is known as Meige syndrome.
The primary treatment is injections of botulinum toxin (Botox) directly into the muscles around the eyes. These injections temporarily weaken the muscles, reducing spasms and improving the ability to keep the eyes open. Other options may include oral medications, although they are generally less effective, and in severe cases, surgery to remove some of the eyelid muscles.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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