To the Editor.
—The ophthalmologic community has shown a resurgent interest in essential blepharospasm. Treatment of this disorder commonly includes medical therapy with a host of occasionally effective agents, excision of the appropriate segments of the facial nerve,1-3 and excision of the orbicularis, procerus, and corrugator muscles.4 More recently, the injection of botulinum toxin has been used with promising results. Although these methods have been moderately successful, it is often difficult to judge the severity of the condition during a preoperative evaluation. Since these modes of treatment are not without perioperative and long-term morbidity, it is necessary to determine accurately which patient requires this type of intervention. Numerous patients may have a history compatible with essential blepharospasm, but their objective symptoms, on prolonged observation in the surgeon's office, seem minimal compared with the degree of disability described. We have been using a simple test to elucidate the actual
Gladstone GJ, Putterman AM. A Repetitive Forced Closure Test. Arch Ophthalmol. 1985;103(4):477–480. doi:10.1001/archopht.1985.01050040019008
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