An eyelid twitch, or blepharospasm, is a repetitive, involuntary spasm of the eyelid muscles. A twitch usually occurs in the upper lid, but 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 experience any twitching for weeks or even months.
The twitches are painless and harmless, but they may bother you. 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 usually investigated. Nevertheless, eyelid twitches may be caused or made worse by:
- eye irritation
- eyelid strain
- lack of sleep
- physical exertion
- medication side effects
- use of alcohol, tobacco, or caffeine
If the spasms become chronic, you may have what’s known as “benign essential blepharospasm,” which is the name for chronic and uncontrollable eyelid movement. This condition typically affects both eyes. The exact cause of the condition is unknown, but the following may make spasms worse:
- blepharitis, or inflammation of the eyelid
- conjunctivitis, or pinkeye
- dry eyes
- environmental irritants, such as the wind, bright lights, the sun, or air pollution
- light sensitivity
- too much alcohol or caffeine
Benign essential blepharospasm is more common in women than in men. According to Genetics Home Reference, it affects approximately 50,000 Americans and usually develops in middle to late adulthood. The condition will likely worsen over time, and it 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 symptoms. Brain and nerve disorders that may cause eyelid twitches include:
- Bell’s palsy (facial palsy), which is a condition that causes one side of your face to droop downward
- dystonia, which causes unexpected muscle spasms and the affected area’s body part to twist or contort
- cervical dystonia (spasmodic torticollis), which causes the neck to randomly spasm and the head to twist into uncomfortable positions
- multiple sclerosis (MS), which is a disease of the central nervous system that causes cognitive and movement problems, as well as fatigue
- Parkinson’s disease, which can cause trembling limbs, muscle stiffness, balance problems, and difficulty speaking
- Tourette’s syndrome, which is characterized by involuntary movement and verbal tics
Undiagnosed corneal scratches can also cause chronic eyelid twitches. If you think 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’re having chronic eyelid spasms and any of the following also happens:
- Your eye is red, swollen, or has an unusual discharge.
- 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 eyelid spasms go away without treatment in a few days or weeks. If they don’t go away, you can try to eliminate or decrease potential causes. The most common causes of eyelid twitch are stress, fatigue, and caffeine. To ease eye twitching, you might want to try 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.
Botulinum toxin (Botox) injections are sometimes used to treat benign essential blepharospasm. Botox 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. Physical therapy may also be useful for training the muscles in your face to relax.
Lifestyle treatments may also help ease the symptoms of benign essential blepharospasm. Coenzyme Q10 is one treatment, but you should ask your doctor about it first if you have Parkinson’s disease. Treatments also include:
If your eyelid spasms are happening more frequently over time, keep a journal and note when they occur. Note your intake of caffeine, tobacco, and alcohol, as well as your level of stress and how much sleep you’ve been getting in the periods leading up to and during the eyelid twitching.
If you notice that you get more spasms when you aren’t getting enough sleep, try to go to bed 30 minutes to an hour earlier to help ease the strain on your eyelids and to reduce your spasms.
Eyelid twitches have many causes. The treatment that works and the outlook varies depending on the person. Research is being done to see if there’s a genetic link, but it doesn’t seem to run in families. Twitches related to stress, lack of sleep, and other lifestyle factors have the best outlook. If an underlying health condition is the cause, then treating the underlying condition is the best way to relieve the twitching.