Blepharospasm (Eyelid + Facial Twitching)

Functional oculoplastic surgery focuses on the eyelids, eye sockets and facial structures around the eye area. It’s a highly specialised surgical procedure combining ophthalmology and plastic surgery. The surgeries are also delicate and involve operating on incredibly fine structures.


Eyelid twitching is a common occurrence with various causes, not all of which necessitate immediate concern. Usually, this phenomenon is a brief and mild experience that may occur randomly or be attributed to factors such as irritation, blepharitis, or fatigue, and is known as myokymia.

Typically, myokymia resolves on its own within a few days, and treatment is generally unnecessary.

How does blepharospasm present?

A less common and more persistent condition leading to eyelid twitching is called blepharospasm. This condition can affect one or both eyelids, ranging from infrequent and mild episodes to persistent and severe instances. Blepharospasm is characterised by involuntary blinking or twitching of the eyelids, often occurring without an apparent trigger.

How is blepharospasm treated?

While mild cases of blepharospasm may be possible to live with, severe instances can significantly disrupt daily life, affecting confidence and even causing vision problems. Blepharospasm can affect all genders and ages but tends to be more common in middle-aged females.

Patients presenting with blepharospasm at an optician should always be referred to an oculoplastic specialist for a thorough clinical assessment to rule out any underlying pathology. Following this assessment, a treatment strategy is devised, typically starting with the identification of triggers and non-invasive interventions.

Is surgery for blepharospasm necessary?

In cases where intervention is necessary, personalised treatment plans involving muscle relaxing injections have proven highly effective in managing and sometimes alleviating blepharospasm. Surgical intervention is reserved for the rare and severe cases of blepharospasm.

Dr Nick Koutroumanos, an Honorary Consultant at the National Hospital for Neurology and Neurosurgery, collaborates closely with specialists from various disciplines.

Furthermore, he also looks after individuals with less common forms of dystonias, such as Hemifacial Spasm, Cervicofacial Dystonia, and Meige Syndrome. Many patients under his care experience satisfactory control and often resolution of their symptoms.

Oculoplastic surgeon London


Dr Nick Koutroumanos

Dr Nick Koutroumanos is a London-based Ophthalmic & Oculoplastic surgeon, with particular subspecialty expertise in ophthalmic plastic & reconstructive eyelid, orbital and lacrimal surgery.

His private practice, based at The Hospital of St John & St Elizabeth in St John’s Wood complements his work in charge of a large NHS oculoplastics practice at the Royal Free Hospital in Hampstead.

A qualified senior trainer and Royal College Examiner in ophthalmic plastic surgery, cataract surgery and general ophthalmology, he runs an Oculoplastics Fellowship training programme that is highly sought-after by both UK and international candidates.

Kind Words from Our Patients


A true perfectionist

Words are not enough to express my sincere gratitude for the care and dedication Dr Koutroumanos put into my journey. I felt safe and secure in his hands. This is someone who truly cares about outcome and ethics of practice. A true perfectionist. I would not hesitate to wholeheartedly recommend him.

100% worth it

I had surgery a few days ago with Dr Koutroumanos for congenital ptosis. It’s early days but I don’t think it’s too early to say the results will be life changing for me in terms of confidence levels. I struggled at school due to the condition and have learnt to live with it – that is until I saw the doctor who was reassuring from the start and has just done the best job. 100% worth it and amazing to know I was in such safe hands. I can’t thank him enough.

I’m really happy with my results

I’ve recently had a brow lift and blepharoplasty with Mr N Koutroumanos. The whole process from start to finish was handled professionally and each process was very informative. I’m still at the recovery stage, so far I’m really happy with my results. Highly recommend using Mr N Koutroumanos services.