Which statement best describes blepharospasm management?

• A. This condition is malignant and requires urgent surgery
• B. It is benign but can cause vision impairment if severe; manage with frequent PFATs and Botox referrals; follow up in 1 year or sooner if worse
• C. No treatment is ever needed
• D. Oral steroids are the only treatment

Answer: (B)

Blepharospasm is a benign focal dystonia where the eyelids spasm and can close involuntarily, and vision can become functionally affected if the spasms are severe. The best management centers on reducing the spasms with botulinum toxin injections into the eyelid muscles, usually coordinated with referrals and ongoing assessments such as frequent PFATs to monitor function and response. Regular follow-up is important, typically about once a year, but sooner if symptoms worsen. This approach is preferred because it directly targets the dystonic muscle activity with a safety profile suited for eyelid treatment, rather than pursuing urgent surgery or relying on ineffective or inappropriate therapies.