Functional blindness: Blepharospasm

A 62 year-old female was referred to our clinic with a complain of inadequate opening of her eyes for 2 years. As a result of the examinations done in the neurology clinic of a university hospital, the essential blepharospasm was diagnosed to the patient. The blepharospasm, combined with apraxia of eyelid opening, had restricted the patient's daily life. The surgery was planned in the patient who did not improve after Botulinum toxin injection. Limited myectomy and aponeurotic plication were performed concurrently. Ptotic brow and blepharochalasis were corrected. Adequate lid opening was achieved after the procedure. We emphasize that myectomy and aponeurotic plication of levator aponeurosis may be considered instead of frontal nerve surgery and/or blockage of superior cervical ganglion which is a more traumatic procedures, especially in patients who have insufficient response to Botulinum toxin injection.