Eyelid twitches are common and may have different causes, such as eye irritation, strain, or lack of sleep. Chronic and long lasting spasms may be a sign of other conditions.

An eyelid twitch or contraction is a repetitive and involuntary spasm of the eyelid muscles.

Eyelid twitches typically occur in unpredictable periods lasting between a few seconds and hours. Chronic twitching could last for a few days or weeks.

Most twitches are painless, harmless, and will resolve on their own without 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 tics or uncontrollable movements.

A note on sex

Sex and gender exist on spectrums. We use “male” and “female” in this article to reflect the anatomy and chromosomes of sex assigned at birth.

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Eyelid twitches may be classified into three types based on their frequency, severity, and underlying causes.

Myokymia

Myokymia refers to sporadic eyelid spasms that typically affect the lower lid. They’re fairly common and are rarely a sign of a serious problem.

They typically feel like gentle, mild tugs. But you could also experience occasional spasms that force both the upper and lower lids shut.

These contractions may occur due to several environmental factors and generally disappear with rest.

That said, if these twitches are persistent and disrupt your life, speak with a doctor. They may be a sign of an underlying condition.

Benign essential blepharospasm

Chronic and sustained eyelid spasms may be a sign of benign essential blepharospasm, a type of movement disorder (dystonia) that can affect both eyes.

Females are 2.3 times more likely to be affected than males.

The condition typically peaks between ages 50-70. It may worsen over time and potentially cause:

  • blurry vision
  • increased sensitivity to light
  • facial spasms

Hemifacial spasm

Eyelid twitches that affect only one eye may be a sign of hemifacial spasm. This is a neuromuscular disorder usually caused by a blood vessel putting excess pressure on one of your facial nerves.

It typically starts with episodic twitching of one eyelid. Gradually, the spasms may lead to one eye closing and the mouth being pulled to one side.

Eventually, hemifacial spasms might affect all muscles on one side of the face.

According to the National Institute of Neurological Disorders and Stroke, hemifacial spasms are more common in females than males. The condition is also more common in Asian people.

The most common causes of eyelid twitching include:

Other triggers and causes of eyelid twitching include:

Eyelid twitches are common and rarely require emergency medical treatment.

But chronic eyelid spasms can be a symptom of a more serious brain or nervous system disorder, such as:

Contact a doctor if you’re having chronic eyelid spasms and any of the following symptoms:

  • your eye is red, swollen, or has 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 may have an eye injury, contact an optometrist or ophthalmologist immediately. Corneal scratches can cause permanent eye damage.

Most eyelid spasms go away without treatment within a few days.

If they don’t go away, you could try to eliminate or decrease potential causes by:

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

If your eye twitching is persistent and disrupts your daily life, speak with a doctor.

Depending on the cause, further treatments may be suggested, such as:

  • antibiotics
  • botulinum toxin (botox)
  • surgery

Botox injections are used to help treat benign essential blepharospasm. It may ease severe spasms for a few months. But, as the effects of the injection wear off, you may need further injections.

For more severe cases of benign essential blepharospasm, surgery may be needed to remove some of the muscles and nerves in the eyelids (myectomy).

If your eyelid spasms are happening more frequently, try keeping a journal.

Note down when your spasms occur, along with your:

  • caffeine, tobacco, and alcohol intake
  • level of stress
  • quantity of sleep

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 eyes and reduce your spasms.

Why does my eyelid keep twitching?

Eyelid twitching is common and isn’t typically a cause for concern.

The most common causes of eyelid twitching include:

  • fatigue or lack of sleep
  • stress or anxiety
  • exercise
  • caffeine, tobacco, or alcohol consumption

If your eyelid twitching persists for over a week or is accompanied by other symptoms, speak with a doctor. This may be a sign of an underlying condition.

Eyelid twitches can have many causes, though they’re rarely cause for concern.

If you’re eyelid contractions are constant and don’t go away, contact a doctor. The twitching may be a sign of a more serious condition.

Treatments, prevention strategies, and outlooks vary from person to person. But twitching related to stress, lack of sleep, and other lifestyle factors have the best outlook.