An eyelid twitch (blepharospasm) is a repetitive, involuntary spasm of the eyelid muscles. A twitch usually occurs in the upper lid, although it can occur in both the upper and lower lids. For most people, these spasms are very mild and feel like a gentle tug on the eyelid. Others may experience a spasm strong enough that it forces you to close your eyelid completely. Some people never have any noticeable signs.
Spasms typically occur every few seconds for a minute or two. Episodes of eyelid twitching are unpredictable—the twitch may occur off and on for several days. Then, you may not have any for weeks or even months.
The twitches are painless and harmless, though they may be a nuisance. Most spasms will resolve on their own without the need for treatment.
In rare cases, eyelid spasms may be an early warning sign of a chronic movement disorder, especially if the spasms are accompanied by other facial twitches or uncontrollable movements.
Eyelid spasms may occur without any identifiable cause, and because they are rarely a sign of a serious problem, the cause is not often investigated. Nevertheless, eyelid twitches may be caused or made worse by:
- eye irritation
- eyelid irritation (conjunctiva)
- lack of sleep
- physical exertion
- side effects of medication
- use of alcohol, tobacco, or caffeine
If the spasms become chronic, you may have what’s known as benign essential blepharospasm, the name for chronic and uncontrollable eyelid movement. This condition typically affects both eyes, and though the exact cause of the condition is unknown, the following may make spasms worse:
- blepharitis (inflammation of the eyelid)
- conjunctivitis (pinkeye)
- dry eyes
- environmental irritants, such as wind, bright lights, the sun, or air pollution
- light sensitivity
Benign essential blepharospasm is more common in women than men. It affects approximately 50,000 Americans and usually develops in middle to late adulthood. The condition will likely worsen over time, and may eventually cause blurry vision, increased sensitivity to light, and facial spasms.
Very rarely, eyelid spasms are a symptom of a more serious brain or nerve disorder. When the eyelid twitches are a result of these more serious conditions, they are almost always accompanied by other telltale symptoms. Brain and nerve disorders that may cause eyelid twitches include:
- Bell’s palsy (facial palsy): a condition that causes one side of your face to droop downward
- dystonia: this condition causes unexpected muscle spasms that cause the affected area’s body part to twist or contort
- cervical dystonia (spasmodic torticollis): this form of dystonia causes the neck to randomly spasm and the head to twist into uncomfortable positions
- Parkinson’s disease: a disease that can cause limb-trembling, muscle stiffness, balance problems, and difficulty speaking
- Tourette syndrome: a condition characterized by involuntary movement and verbal tics (quirks)
Undiagnosed corneal scratches can also cause chronic eyelid twitches. If you suspect you have an eye injury, see your optometrist immediately. Corneal scratches can cause permanent eye damage.
Eyelid twitches are rarely serious enough to require emergency medical treatment. However, chronic eyelid spasms may be a symptom of a more serious brain or nervous system disorder. You may need to see your doctor if you are experiencing chronic eyelid spasms and also exhibit any of the following symptoms:
- Your eye is red, swollen, or has an unusual discharge.
- You notice your upper eyelid is drooping.
- Your eyelid completely closes each time your eyelids twitch.
- The twitching continues for several weeks.
- The twitching begins affecting other parts of your face.
Most episodes of eyelid spasms typically resolve without treatment in a few days or weeks. If they do not, you can try to eliminate or decrease potential causes. The most common causes of eyelid twitch are stress, fatigue, and the use of caffeine. To ease eye twitching, you might want to try any of the following:
- Drink less caffeine.
- Get adequate sleep.
- Keep your eye surfaces and membranes lubricated with over-the-counter artificial tears or eye drops.
- Apply a warm compress to your eyes when a spasm begins.
Benign essential blepharospasm is sometimes treated with botulinum toxin (Botox) injections. The injections may ease severe spasms for a few months. However, as the effects of the injection wear off, you may need further injections. Surgery to remove some of the muscles and nerves in the eyelids (myectomy) can also treat more severe cases of benign essential blepharospasm.
Lifestyle treatments—such as acupuncture, hypnosis, and nutrition therapy—may also help ease the symptoms of benign essential blepharospasm.
If you are experiencing increasingly frequent episodes of eyelid spasms, keep a journal and note when they occur. Also, pay attention to your intake of caffeine, tobacco, and alcohol, as well as your level of stress and how much sleep you have been getting in the periods leading up to and during the eyelid twitching. If you notice your spasms are more common when you are not getting adequate rest, make an effort to go to bed 30 minutes to an hour earlier to help ease strain on the eyelids and to reduce your spasms.