Botulinum toxin for blepharospasm – a retrospective review

Purpose: Essential blepharospasm can be treated effectively with regular injections of botulinum toxin. The aim of this retrospective study was to evaluate long-term data from patients treated with regular injections over 9 years.

Material and Methods: Treatment efficacy and clinical outcomes were investigated retrospectively over a period of 9 years. 9 patients (30%) had unilateral and 21 bilateral blepharospasm (70 %). The standard injection record cards, which included injection site, dosage and documentation of side effects and efficacy, were analyzed.

Results: The long-term data over 9 years in 30 patients with 520 treatment sessions showed subjectively positive results in almost 80 % without relevant short-term or long-term side effects. Treatment had to be repeated after an average of 105 days when the effect wore off. The only long-term side effect was asymmetric wrinkling after more than 5 years of regular injections for unilateral blepharospasm.

Conclusion: Essential blepharospasm can be treated effectively with regular injections of botulinum toxin. It is generally a long-term therapy. Education about the clinical presentation and sensitization to the variable and non-specific symptoms and treatment options is important for all ophthalmology-associated professional groups.