Blepharospasms 10 Months After Surgery

Question

I am 43 and had surgery 10 months ago.  I still have mild lid numbness, but in the past month have developed blepharospasms.  They occur all day long.  I feel one lid get very heavy then it will begin to spasm.  Then the other lid starts right after.  I started taking extra vitamins thinking I was deficient.  I use lubricating drops regularly without relief.  My doctor is telling me I need Botox shots to stop the twitching.  It is interfering with my work.  My swelling status post surgery took about 5 months.  I feel that I did not heal well either and I always thought I healed well from surgery in the past.  Anyone have any other suggestions?  I am very worried about having these shots in my eyelids!  This has been my worst surgical recovery ever.

Mehryar (Ray) Taban, MD, FACS · Answer

There are variety of conditions that can cause eyelid spasm/twitching. True blepharospasm is unlikely in your case but it is possible. Another possibility is aberrant regeneration, which happens if the facial motor nerve is injured and then it recovers but fires abnormally. The best treatment option is periodic botulinum toxin (Botox) injections. These injections are safe and have been used for last 30 years, for the cosmetic reasons and functional reasons. See an oculoplastic surgeon to first determine the cause of your eyelid spasms and then discuss possible solutions.

A.J. Amadi, MD · Answer

The spasms you are describing are called Ocular Myokymia. It is likely unrelated to the surgery. These spasms are usually attributed to increased stress, lack of sleep, or increased caffeine intake, and behavior modification is recommended [stress relief activities, decreased caffeine intake, or increased sleep.

	In refractory cases, botox injections are indicated. Very low dosages are required so you should not be worried about the "shots"

Alexander Ovchinsky, MD · Answer

Sorry to hear about your difficult recovery. When you say surgery, I assume blepharoplasty, correct? During blepharoplasty, the muscle around the eyelid is frequently cut to get to the fat or to improve definition. Along with other valid reasons for blepharospasm mentioned in earlier responses, physical insult on the muscle by surgery can also be the cause of this problem. I would consider Botox treatment which should improve this problem.

Amiya Prasad, MD - Account Suspended · Answer

If you had "routine" cosmetic eyelid surgery, it's concerning to have problems with swelling and spasm 10 months after surgery. It still may be advisable to have some Botox injected to reduce the spasm and address your discomfort. If you are concerned about the surgery itself, an opinion from a highly experienced eyelid specialist may assist you with your situation.

Robert Shumway, MD - Account Suspended · Answer

I know just how much blepharospasms can annoy people because I occasionally develop these localized spasms if I do not get enough sleep. Stress and caffeine are important issues to discuss with your doctor too.

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