Abstract: Idiopathic blepharospasm is a form of focal dystonia. It is generally believed that the pathogenesis is related to the damage of the basal ganglia of the brain, hypoactive nigrostriatal gamma-aminobutyric acid neurons, hyperactive cholinergic neurons, or decreased inhibition of the cerebral cortex. The disease is more common in the middle-aged and elderly population, and is more common in female than male. The typical symptom contains forceful involuntary spasms of eye closure，which usually occurs in quiet or when gazing at people or objects. A clinical guideline for diagnosing blepharospasm can help physicians confirming or refuting suspected IBSP. The Shorr grade, a scale for rating the severity of IBSP availably, contains 5 levels depending on the degree of blepharospasm. It is a safe and effective method to inject appropriate dose of botulinum toxin into orbicularis oculi muscles for treating mild to moderate blepharospasm. (Int Rev Ophthalmol, 2022, 46: 415-419)

Key words: idiopathic blepharospasm, botulinum toxin