Vision

Are your eyes closing uncontrollably?

It is not common for people with Parkinson’s disease to experience involuntary closure of the eyes, but it does occur in some cases. This phenomenon has been referred to as blepharospasm, pronounced ['blef-a-ro-spaz-m' (click to hear it)]. “Blepharo” refers to the eyelid, and “spasm” is defined as an uncontrollable muscle contraction.

If you are experiencing involuntary eye closure, it is important to see an ophthalmologist first. There are many conditions that can cause involuntary eye closure, and these conditions are not related to Parkinson’s disease. They include:

  • an inflammatory eye condition due to an infection or an allergy
  • dry eyes
  • damage to the surface of the eye
  • ptosis (A person’s eyelid appears to be “drooping.” It can be caused by muscle weakness, nerve damage, or looseness of the eyelid skin. This is often associated with normal aging.)
  • other conditions

If the ophthalmologist determines that the aforementioned conditions do not account for the eye closure, the next step for patients is to see their neurologist to determine whether their PD medications are optimized.  The involuntary eye closure may or may not be related to doses of PD medications (Optimizing your medications refers to a process in which you and your doctor work to find the medication regimen from which you derive the greatest benefit).

If eyelid closure remains a problem after medications have been optimized, then injection of botulinum toxin, also called botox, every 3-4 months in the muscles around the eyelids has been found to be a very effective treatment. 

In rare cases, botulinum toxin may be ineffective, and it may be helpful to consult a movement disorder specialist (MDS), a neurologist with expertise in movement disorders like Parkinson’s disease. An MDS can help determine whether the diagnosis is correct.  Sometimes blepharospasm can be confused with another condition called “apraxia of eyelid opening.”

Sources

Dr. Michael S. Okun, NPF National Medical Director and Co-Director of the University of Florida Center for Movement Disorders & Neurorestoration
Benign Essential Blepharospasm Research Foundation
National Library of Medicine

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