If a patient has an tic doloreaux/blepharospasm, is Botox injection into orbicularis muscle the best treatment?

Also, are oculoplastic surgeons better at this procedure or can any "general" opthalmologist be perfectly fine and capable at doing this?

My residents do it all the time.

It's standard of care for severe debilitating blepharospasm or hemifacial spasm. At least those that are idiopathic and not caused by a tumor at the cerebellopontine angle.

I would get it done by oculoplastics. But if one isnt available a general guy might do it.

Botox was originally used for this, correct? And then they realized it worked for wrinkles. Then Allergan bought it.

Botox is the standard for blepharospasm and hemifacial spasm. I have been injecting for this condition since the 1990's.

It used to be called ocutox but I think it was used for strabismus first not spasm.

I've never known a neuroophthalmologist who did not offer Botox services for patients with the various ocular/facial dystonias. Many (most? all?) movement disorder neurologists also do these injections.

There is no mystery involved with giving Botox. If you are using it to get rid of fine lines and wrinkles, then I would probably prefer to consult a plastic surgeon. If you are using it to help with a functional problem (like this one) visiting an ophthalmologist is fine.

I'd suggest an oculoplastics specialist or someone that knows ophthalmology and botox for cosmetic use.