The left side of this patient is twitching involuntarily.
Eye twitching / blepharospasm or hemifacial spasm
While eyelid twitching /eye spasm occasionally can occur in most people , it can become persistent, excessive, involuntary and adversely affect people’s lifestyle in which s/he may not be able to open his/ her eyes to see. Sometimes it can affect one side of face (hemifacial spasm) which causes significant social embarrassment and self - consciousness. The cause are multifactorial, ranging from idiopathic (unknown cause) and tumour or vascular loop in brain compressing on facial nerve. It is often aggravated by dry eyes and emotional distress. MRI of brain is sometimes required to establish diagnosis.
The treatment is usually botulinum toxin ( botox injection) onto affected muscle. Effects usually last for three months. However, Dr Ho recently noted that coupling with addressing underlying issue ( emotional distress, incorrect posture) can help to achieve more sustainable remission and less Botox injection.
In the event of recalcitrant condition resistant to Botox treatment, surgery can be performed to treat the condition. If the cause of the condition is vascular loop compressing on the nerve, then surgical decompression.
Pre op: This patient is not able to open both of his eyes. He has multiple botox injection which has not been helping.
Post op: This patient has myomectomy (remove muscle which close his eyes) . For the first time after many years, he is able to open his eyes and see well.
Pre treatment: Patient struggle to open both eyes despite effort.
Post treatment: Patient can open both eyes widely and comfortably now.