Objective: A case report demonstrating successful treatment of Meige syndrome with FL-41 rose-tinted lenses.

Background: Meige syndrome is a rare disorder characterized by blepharospasm and oromandibular dystonia. Several treatment modalities have been described in the literature previously to various effect. Although FL-41 lenses have been used with success in blepharospasm, to our knowledge this is the first description of successful use in Meige syndrome. We propose the use of FL-41 glasses as another therapeutic option for patient with Meige syndrome.

Method: A 65-year-old African American male presented with a ten-year history of refractory Meige syndrome. His past medical history was also significant for hypertension, dyslipidemia, and cervical dystonia. Physical exam was notable for episodic involuntary contractions of bilateral orbicularis oculi muscle consistent with blepharospasm as well as concurrent intermittent spasms of the lower facial muscles and jaw consistent with oromandibular dystonia. Magnetic resonance imaging and laboratory studies were unremarkable for secondary causes of Meige syndrome. He was trialed without improvement on several medications, including tetrabenazine, deutetrabenazine, valbenazine, clonazepam, baclofen, trihexyphenidyl, zolpidem, and several rounds of botulinum toxin injections. He also underwent a brow lift without improvement. Patient was then trialed on FL-41 rose-tinted lenses.

Results: The addition of FL-41 lenses provided significant subjective and objective relief of the patient’s signs and symptoms. He noted significant decrease in severity and frequency of his blepharospasm and facial grimacing.

Conclusion: The exact pathophysiology of Meige syndrome is not well understood. Blepharospasm has been shown to be associated with photophobia. The authors thereby suggest a correlation between Meige syndrome and the trigeminovascular system, given that our patient experienced significant relief of both blepharospasm and oromandibular dystonia when using FL-41 lenses. We therefore propose FL-41 lenses as an alternate noninvasive therapeutic option for patients with Meige syndrome.

References: [1] Wu Y, Hallett M. Photophobia in neurologic disorders. Transl Neurodegener. 2017;6:26. Published 2017 Sep 20. doi:10.1186/s40035-017-0095-3 [2] Jahngir MU, Patel BC. Meige Syndrome. [Updated 2019 Jun 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 [3] Blackburn MK, Lamb RD, Digre KB, et al. FL-41 tint improves blink frequency, light sensitivity, and functional limitations in patients with benign essential blepharospasm. Ophthalmology. 2009;116(5):997–1001. doi:10.1016/j.ophtha.2008.12.031

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