Blepharotic

BLEPHAROTIC (synonyms: blepharoclonus, spasmus nictitans, or nictitatio), clonic spasms of the musculus orbicularis oculi, consisting of frequent blinking. The closure and opening of the eyelids in this condition occur rapidly and without any apparent cause. Frequently, the period of eyelid closure is longer than normal, and the opening movement takes place more slowly.—Tonic spasms of the m. orbicularis oculi are termed blepharospasm. Often, clonus and spasm of the m. orbicularis oculi occur simultaneously, or both forms of spasms transition into one another or rapidly replace each other. The strength and duration of the spasms vary greatly. Among subjective sensations, one may note a feeling of tension, constriction, and eye fatigue. According to their mode of origin, spasms are divided into involuntary, voluntary, and reflex; according to the site of lesion, into central and peripheral.—Involuntary spasms of the m. orbic. oculi occur in a whole series of functional motor neuroses and diseases of the cerebrospinal system. They may be isolated or form part of a tic convulsif. In tic convulsif or tic general, in a large number of cases, frequent blinking is the first symptom and is accompanied by twitching of the muscles of the face, neck, hands, wrists, and lower extremities. The twitches produce the impression of regular movements having a definite meaning. Sometimes the tic is accompanied by the phenomenon of micropsia, caused by a spasm of the accommodation muscle. Frey considers the tic to be a motor reaction of diseased nerves to psychological irritants.—The course of blepharotic is chronic; complete recovery is hardly possible. Young individuals fall ill during the puberty period. At the root lies a congenital nervous predisposition, on the basis of which, especially due to fright, blepharotic manifests itself. It occurs in cortical epilepsy, hysteria, traumatic neurosis, chorea, tetany, chlorosis, neurasthenia, diseases of the digestive tract, and enteroptosis.—Voluntary spasms—or, as they are called, "habitual" ones—consist of blinking. Excessive, unnecessary blinking can turn into a pathological state that remains constant in the absence of volitional counteraction; the spasms can be suppressed by an effort of will. Often spasms occurring exclusively in childhood and youth are accompanied by twitching of the mouth and shaking of the head, which, however, ceases during sleep.—Reflex spasms occur mainly in the form of blepharospasm. Treatment of blepharotic is general, namely: tonics, hydrotherapy, arsenic, bromine. N. Pletnyova. BLEPHAROPHIMOSIS (from Greek blepharon—eyelid and phimos—muzzle), blepharophimosis, narrowing of the palpebral fissure in the horizontal direction. It is sometimes observed as a congenital condition in connection with microphthalmus, epicanthus, and congenital ptosis. More frequently, blepharophimosis is the result of chronic inflammation of the ciliary margin of the eyelids (blepharitis), especially when localized at the outer commissure, where the ulcerated, mutually contacting edges of the eyelids tend to fuse with one another. Most often, especially in countries with endemic trachoma, blepharophimosis arises as a consequence of this disease and is frequently accompanied in such cases by trichiasis and entropion. Blepharophimosis has an adverse effect on the course of pathological processes in the eyelids and the anterior segment of the eyeball, and hinders the proper application of therapy (complicates eye operations). Prevention of blepharophimosis includes rational treatment of inflammations of the ciliary margin of the eyelids, fissures, and trachoma. Treatment consists of canthoplasty.