DEAR DR. GOTT: I enjoy reading your column and your common sense approach to many health issues.
A friend of mine who is a nurse and worked for a doctor had a problem which caused her much grief. Her eyes were dry and would clamp shut. She couldn’t open them at appropriate times, such as when driving. She had a couple minor accidents as a result.
One day when her husband was at the eye doctor, he mentioned her problem to the doctor who rattled off some big name condition, blepharospasms. She was examined by him later and diagnosed.
The treatment is Botox injections on a regular basis. It has improved her quality of life. I don’t know if this could be helpful to your readers.
DEAR READER: Blepharospasm is a focal dystonia or abnormal blinking or closing of the eyes that commonly begins rather slowly but progresses over time. It is linked with abnormal functioning from the part of the brain responsible for controlling muscles. It can develop without warning but may be preceded by stress, a light sensitivity (photophobia), stressful driving, or even fatigue. Some individuals can experience such severe symptoms that their eyes remain forcefully closed for hours at a time. Those most commonly affected are in their 50s and 60s, with women being three times more prone than men. As the condition progresses in intensity, the spasms of the eyelids increase until they are continuous and the eyes simply close. The condition is linked with some neurological conditions such as Parkinson’s disease and can even be a side effect of some medications, yet oddly enough, symptoms can be lessened or cease altogether while a person sleeps or indulges in an activity that requires close concentration. While there is no cure, there are treatment options available to lessen the severity of the condition.
There is oral medication available; however, the results are less than optimal and remain a poor choice overall. Relief with drugs is short term and only helpful in 15% of all reported cases. As you have indicated, Botox injections (botulinum toxin) injected into the muscles of the eyelid has proven successful and appears to be the preferred treatment choice with results lasting several months. Because only minimal amounts are injected, periodic follow-up injections are necessary for control. On the downside but very uncommon, Botox can result in eyelid drooping, dry eyes and diplopia (double vision). For those who either don’t prefer Botox or have tried it without success, there is myectomy, an actual surgical procedure that removes a portion of the nerves and muscles of the eyelids. This procedure, while appearing frightening, has lessened symptoms in up to 85% of people diagnosed with blepharospasms.
I’m always uncomfortable with conditions of the eyes because we only get one set and must protect them in every possible way. If your friend has had success, I think that is wonderful. I can only recommend readers find the most qualified ophthalmologist to be in control of their eyes – particularly when it comes to invasive procedures. Thank you for sharing your thoughts.
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