Eyelid twitches, or myokymia, can be caused by eye irritation, eye strain, lack of sleep, dry eyes, or too much caffeine. Severe or long lasting eyelid spasms may be a sign of other conditions.

An eyelid twitch, or myokymia, 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 mild and feel like a gentle tug on the eyelid. Others may experience a spasm strong enough to force both eyelids to close completely. These spasms typically occur every few seconds for a minute or two.

Episodes of eyelid twitching are unpredictable. The twitch may occur on and off for several days. Then you may not experience any twitching for weeks or even months.

The twitches are typically 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.

Sex and gender exist on spectrums. We use “women” and “men” in this article to reflect the terms that have been historically used to gender people.

Eyelid twitching can be classified into three types:

  • general eyelid spasm
  • essential blepharospasm
  • hemifacial spasm

General eyelid spasm

Some amount of eyelid spasms can be considered typical and doesn’t indicate any kind of serious problem. These twitches can arise from a variety of environmental factors, and generally disappear with rest. If these twitches are persistent and disrupt your life, you may want to speak with your doctor about your symptoms.

Benign essential blepharospasm

If the spasms become chronic (long term), you may have what’s known as benign essential blepharospasm, which is the name for chronic and uncontrollable winking or blinking.

This condition typically affects both eyes and is more common in women than in men.

It affects up to 50,000 people in the United States 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
  • facial spasms

Hemifacial spasm

If the eyelid twitch affects just one eye, a hemifacial spasm is a possibility. This type of spasm is a neuromuscular disorder usually caused by a blood vessel putting excess pressure on one of your facial nerves.

This disorder is more common in women than in men, and it’s also more common in people from Asia. If left untreated it may cause:

  • frequent, uncontrollable eye twitching
  • an inability to open your eye
  • twitching in all muscles of one side of your face

Eyelid twitching can stem from a wide variety of causes. If this symptom is bothering you, it may help to discuss it with your doctor.

Eyelid twitching or spasms may be caused or made worse by:

Rarely, eyelid spasms are a symptom of a more serious brain or nerve disorder. When eyelid twitches are a result of these more serious conditions, they’re 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 your affected area’s body part to twist or contort
  • cervical dystonia (spasmodic torticollis), which causes your neck to randomly spasm and your head to twist into uncomfortable positions
  • multiple sclerosis (MS), which is a disease of the central nervous system that causes cognitive and movement problems, fatigue, and eye twitching
  • Parkinson’s disease, which can cause trembling limbs, muscle stiffness, balance problems, and difficulty speaking
  • Tourette syndrome, which is characterized by involuntary movement and verbal tics

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 contact your doctor if you’re having chronic eyelid spasms along with any of the following symptoms:

  • 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 affects other parts of your face.

If you think you have an eye injury, contact your optometrist or ophthalmologist immediately. Corneal scratches can cause permanent eye damage.

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.

To ease eye twitching, you might want to try:

  • drinking less caffeine
  • getting adequate sleep
  • keeping your eye surfaces lubricated with over-the-counter artificial tears or eye drops
  • applying a warm compress to your eyes when a spasm begins

If your doctor determines that intervention is needed, they may recommend antibiotics, surgery, or a variety of other treatment options depending on the exact cause.

Can Botox stop my eye from twitching?

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.

If your eyelid spasms are happening more frequently, try keeping a journal and noting 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 have more spasms when you aren’t getting enough sleep, try going to bed 30 minutes to an hour earlier to help ease the strain on your eyelids and reduce your spasms.

Eyelid twitches have many causes. Treatment and outlook vary depending on the person. Researchers are trying 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.