In 1951 Sidney Fox described an operation for intractable blepharospasm, consisting of removal of most of the orbicularis muscle. His plan was used on the first patient who consulted us because of blepharospasm, which had developed in part from repeated, excessive blinking from keratitis sicca and in part from having a highly nervous temperament.
We removed part of the orbital orbicularis, most of the preseptal part, and some of the pretarsal part of the orbicularis muscle. As the operation proceeded, with the extensive removal of muscle tissue we feared that postoperatively the lids might not close, but this fear was unjustified. Though the blink mechanism was still active, the amplitude and intensity of the sphincter action of the orbicuaris muscles were reduced to a more normal level and the patient was benefited.
This massive removal of the orbicularis muscle with bloody oozing of the muscle tissue and occasional spurting of
CALLAHAN A. Blepharospasm With Resection of Part of Orbicularis Nerve SupplyCorrection of Intractable Cases. Arch Ophthalmol. 1963;70(4):508-511. doi:10.1001/archopht.1963.00960050510013