Essential blepharospasm involves involuntary, bilateral, spasmodic closure of the eyelids caused by contractions of the orbicularis oculi muscles. While often mild, it occasionally may be severe and disabling. Jankovic used a rating scale to determine the severity of the disorder.
Criteria for rating scale:
(1) severity of spasms
(2) functional visual disability
Severity of Spasms
Functional Visual Disability
Severity Rating
no spasms
none
0
minimal with increased blinking, present only with external stimuli
none
1
mild, noticeable eyelid fluttering
none
2
moderate, very noticeable spasms
some visual disability
3
severe and incapacitating, often with spasm of other facial muscles
incapacitating, with functional blindness
4
External stimuli that may trigger blepharospasm include:
(1) bright lights
(2) wind and/or cold to the face
(3) activities like reading or driving
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