A case of apraxia of eyelid opening associated with benign essential blepharospasm in Bhutan

Apraxia of eyelid opening (AEO) is a non-paralytic motor abnormality characterized by difficulty in eyelid opening bilaterally. This is due to the inability of voluntary opening of the eyes in the absence of visible contraction of the orbicularis oculi despite sustained willful frontalis contraction. We present you a case of a 60-year-old woman with AEO associated with benign essential blepharospasm who suffered marked limitation in daily activities due to functional blindness. She was treated with botulinum toxin type A injections following which she had adequate eyelid opening in both eyes during 1 week follow up. It is essential for physicians and patients to be aware of this condition for proper diagnosis and treatment.