[Pay attention to blepharospasm and dry eye]

Blepharospasm-related dry eye is a complex multifactorial comorbidity involving neural, ocular surface, and psychological factors, currently facing core challenges including unclear pathogenesis, ambiguous clinical assessment and diagnostic criteria, non-standardized treatment, and lack of multidisciplinary collaboration. The article proposes that a "dry eye-blepharospasm" vicious cycle may exist with significant individual differences; symptom overlap easily leads to misdiagnosis without unified diagnostic standards or objective indicators; while botulinum toxin type A (BTX-A) is effective, controversies remain regarding dosage and efficacy, necessitating standardization of basic treatments like artificial tears; and establishing a multidisciplinary treatment (MDT) model is urgently needed in clinical practice. Consequently, the authors suggest elucidating mechanisms through multidimensional approaches such as animal models and functional imaging, classifying patients into three subtypes (sensory-triggered, movement-originated, and crossover types) based on onset sequence to establish standardized diagnostic processes, standardizing BTX-A administration with a "low-dose, multi-point, superficial injection" strategy and combination therapies, integrating ophthalmology, neurology, rehabilitation, and psychology resources to build an MDT model, and utilizing artificial intelligence and mobile health technologies for individualized long-term management. Future research should focus on the interaction between neuroinflammation and ocular surface injury, and explore precise combination strategies of BTX-A with novel anti-dry eye medications.