Objective: To explore the inf luence of ocular surface stability secondary to botulinum toxin A injection in patients with essential blepharospasm by comparing the changes in ocular surface indexes. Methods: In this prospective study, 30 patients with essential blepharospasm were recruited and underwent botulinum toxin A injections at the Affiliated Hospital of Yan'an University (January to June 2017). Ocular examinations,including frequency and severity of blepharospasm (using JRS chat), ocular surface symptoms (using OSDI questionnaire), tear break-up time and corneal fluorescence staining with slit-lamp examination, and tear secretion by a Schirmer Ⅰ test, were performed before and 2 weeks after botulinum toxin A injections.Results were analyzed with a paired t-test and spearman correlation test. results: Of the 30 patients (60 eyes) with essential blepharospasm who were enrolled in this study, 60%(18/30) showed dry eye symptoms, and the OSDI scores were positively correlated with JRS scores (r=0.278, P=0.032). Botulinum neurotoxin A treatment relieved blepharospasm in all the patients and JRS scores decreased from 5.5±1.0 to 0.6±1.0 (t=25.730, P<0.001). At the same time, dry eye symptoms also improved in 12 patients (12/18),and OSDI scores decreased from 34.0±7.8 to 21.7±9.1 (t=7.946, P<0.001). BUT increased from 6.3±2.1 s to 8.0±2.0 s (t=4.389, P<0.001), and corneal fluorescence staining scores decreased from 1.0±1.0 to 0.6±0.7 (t=2.963, P=0.004). All the differences were statistically significant. conclusions: Botulinum toxin A injection is effective for dry eye symptoms secondary to essential blepharospasm.