Essential blepharospasm is a facial dystonia characterized by spontaneous, 
spasmodic and involuntary contractions of the eyelid muscles. In advanced cases, 
blepharospasm patients develop severe eyelid spasms that render them 
functionally blind, socially reclusive, and unable to work or care for 
themselves. Oculoplastic surgeons frequently have to deal with patients with 
blepharospasm. The decrease in quality of life caused by this pathology drives 
all the attention to the resolution of the spasms. However, other conditions may 
be associated with them and must be kept in mind during the ophthalmological 
examination. Four patients with essential blepharospasm were diagnosed as 
glaucomatous during their follow-up at the Oculoplastic Service. All of them 
showed glaucomatous optic neuropathy and corresponding visual field defect and 
no clinically apparent secondary cause for their glaucoma. Forced eyelid closure 
may lead to intraocular pressure peaks. These patients with blepharospasm 
present repetitive and spasmodic eyelid contractions and the intraocular 
pressure rise observed during eyelid squeezing could be an additional risk 
factor for glaucomatous damage. Our case series suggest that patients with 
blepharospasm should be seriously evaluated for glaucoma.