Which statement is NOT true regarding BEB?

• A. Botox can be used as treatment
• B. More than 50% will have ocular surface disease
• C. It usually involves unilateral twitching of the eyelids with forced closure
• D. It most commonly affects women between ages 50-70

Answer: (C)

Blepharospasm is a bilateral focal dystonia of the eyelids, causing involuntary, often symmetric blinking and spasms that can progress to forced eyelid closure. Because the condition typically affects both eyes, unilateral twitching is not characteristic. In many patients, ocular surface irritation or dryness accompanies BEB, and more than half will have some ocular surface disease. The condition tends to start in women around ages 50 to 70. The standard treatment is botulinum toxin injections, which relax the muscles and reduce spasms. So the statement about unilateral eyelid involvement is not true; the others reflect common features and management of BEB.