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Eng-King Tan, MD; Alvin Seah, MD

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

We read with interest the study by Hall et al¹ on health-related quality of life (HRQOL) in patients with benign essential blepharospasm (BEB) and hemifacial spasm (HFS). Hall and colleagues demonstrated that those with BEB experienced a greater reduction in a vision-targeted HRQOL and greater anxiety and depressive symptoms compared with patients with HFS.¹ Their choice of HFS as a comparison group rather than healthy controls or controls with non-eye-related disease raises the question of whether their findings could be solely explained by the hypothesis that unilateral symptoms in HFS are better tolerated than the bilateral symptoms in BEB. Instead, the poorer HRQOL in BEB could reflect a referral bias to ophthalmology centers, as ophthalmologists may be seeing the more severe BEB cases compared with HFS. Although eyelid closure is the most common initial manifestation in HFS, the condition almost always involves the lower . . . [Full Text of this Article]

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