Associate Professor Doctor Nguyen Thanh Nam, Director of the High-Tech Eye Center, Tam Anh General Hospital in Ho Chi Minh City, stated that the patient's eyelids twitched continuously and uncontrollably. Each episode lasted 5-10 seconds, occurring every few minutes or hours, sometimes hundreds of times daily. This caused a foreign body sensation and persistent tearing. Visual acuity for each eye was 7/10, and a detailed examination revealed no structural abnormalities.

Associate Professor Nam diagnosed the patient with an orbicularis oculi muscle disorder. This muscle controls eye closure and opening, regulated by the 7th cranial nerve. Disruptions in nerve signal transmission can cause the orbicularis oculi muscle to act abnormally, leading to involuntary eyelid spasms. This condition may affect one or both eyes, either alternately or simultaneously.

Associate Professor Nam examines Mrs. Anh's eyes. *Photo: Tam Anh General Hospital*

The exact cause of eyelid spasms is often difficult to determine, frequently being idiopathic. Stress, lack of sleep, fatigue, or high consumption of coffee and alcohol can trigger or exacerbate these symptoms.

Mrs. Anh received botulinum toxin A injections at several points in the muscles around each eye. This substance inhibits acetylcholine release, a neurotransmitter, temporarily blocking nerve signals to the muscles. This allows the muscles to relax and reduces spasms. Concurrently, the patient was advised to rest, follow a balanced diet, take magnesium supplements, and limit stimulants.

Three days later, at her follow-up, Mrs. Anh's eyelid spasms were controlled. She no longer experienced foreign body sensation or tearing and could open and close her eyes normally, with visual acuity in both eyes reaching 9/10. Associate Professor Nam noted that botulinum toxin A treatment typically remains effective for 3-6 months, depending on the individual. If eyelid spasm symptoms return, patients should visit the hospital for examination, evaluation, and repeat injections as prescribed. There is currently no definitive cure; treatment focuses on controlling spasms, alleviating symptoms, and improving patients' quality of life.

Eyelid spasms commonly affect middle-aged and elderly women. Beyond orbicularis oculi muscle disorder, this condition may be linked to movement disorders, 7th cranial nerve damage, myasthenia gravis, or brain lesions. Patients should seek early medical attention if they experience unusual signs such as prolonged eyelid spasms, progressively worsening symptoms, severe spasms making it difficult to open eyes, or accompanying convulsions or facial numbness.

Ngoc Kim Tham

*Patient's name has been changed

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