A modified Friedenwald-Guyton frontalis sling using a 4-0 polyfilament surgical (Supramid extra) suture is described as a means of decreasing the symptoms of patients visually handicapped by essential blepharospasm. It is a relatively innocuous, simple procedure which can be done under local anesthesia and is reversible by removal of the suture. The sling has not only allowed patients to open their eyelids during spasm by raising their eyebrows, but in some cases has also decreased the frequency and severity of the blepharospasm. Five case reports illustrate these principles.
Putterman AM, Urist M. Treatment of Essential Blepharospasm With a Frontalis Sling. Arch Ophthalmol. 1972;88(3):278-281. doi:10.1001/archopht.1972.01000030280012