What is an eyelid twitch?
Eyelid twitch or twitching is a series of rapid, uncontrolled contractions or spasms of one or all four eyelids (right and left, top and bottom). The twitches often occur in irregular rhythms. The medical term for this symptom is myokymia. Sometimes the term eye twitching is used to describe blepharospasm, a condition characterized by increased involuntary eye blinking symptoms. Blepharospasm is classified as a dystonia, a disorder in which the nervous system signals muscles to contract inappropriately. Blepharospasm typically involves all four eyelids.
Eyelid twitch may occur with other eye symptoms, such as watery eyes and irritated or red eyes or eyelids. Sometimes eyelid twitch appears along with facial tics, which are other involuntary movements of the face including grimacing and nose twitching.
The vast majority of spontaneous eye twitch episodes are benign, self-limited, and leave no clues as to their cause. The most common known causes of eye twitch include fatigue, stress, anxiety, and excessive caffeine intake. Eyelid twitch may appear in response to irritation caused by smoke, dust, or a foreign body in the eye. Allergies and infections may also cause irritation that leads to twitching. Eyelid twitch is seen in primary congenital glaucoma. Various conditions that affect the central nervous system and brain, such as stroke, can also result in eyelid twitch.
In most cases, eyelid twitch goes away on its own with rest or removal of irritating factors. If you have persistent eyelid twitch, contact your health care provider to determine the underlying cause and to obtain any treatment that may be needed.
Eyelid twitch is not an emergency unless it is associated with a stroke. Seek immediate medical care (call 911) if you, or someone you are with, have symptoms of stroke such as sudden numbness or weakness of the face or a limb, especially on one side of the body, sudden confusion, difficulty seeing, sudden vision changes, sudden difficulty with coordination, or sudden severe, unexplained headache.
Eyelid twitch usually goes away on its own. Seek prompt medical care if you have eyelid twitching for several days and it does not resolve within a week, if eyelid twitch closes your eye completely or involves other parts of your face, if you have facial paralysis or partial facial paralysis, if your upper eyelid droops, or if you experience discharge, redness, and swelling in or around the eye.
What other symptoms might occur with eyelid twitch?
Eyelid twitch may accompany other symptoms, which will vary depending on the underlying disease, disorder or condition. Symptoms that frequently affect the eye may also involve other body systems.
Ophthalmologic symptoms that may occur along with eyelid twitch
- Blurred or double vision
- Discharge from the eye
- Drooping eyelid (ptosis)
- Dry eyes
- Eye pain
- Foreign body in the eye
- Increased sensitivity to light
- Itchy eyes
- Watery eyes
Neurologic symptoms that may occur along with eyelid twitch
Eyelid twitch may accompany symptoms related to other body systems. Such symptoms include:
- Disruptive outbursts of speech or gesture
- Facial tics (grimacing, mouth and nose twitching)
- Seizures and tremors
Serious symptoms that might indicate a life-threatening condition
In some cases, eyelid twitch may be a symptom of a life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms:
- Change in level of consciousness or alertness, such as passing out or unresponsiveness
- Facial paralysis
- Facial weakness
- Sudden loss of balance or coordination
- Sudden severe, unexplained headache
What are the different types of eyelid spasms?
Involuntary eyelid spasms typically fall into one of three different categories ranging from mild to serious, and with varying treatments:
- Eyelid twitch (myokymia): This most common type of eyelid spasm can occur in the lids of one or both eyes and typically resolves on its own within a few days. Increased sleep, reduced stress, and lower caffeine intake are effective treatments for myokymia.
- Blepharospasm: This rare type of involuntary movement involves both eyes and often leads to a complete closing of the eyelids during the spasm. The muscles around the eyes may also squeeze, and in some cases, the spasm extends to the mouth and neck muscles. Treatment with botulinum toxin (Botox) is usually effective in relieving symptoms.
- Hemifacial spasm: This more serious spasm is a nervous system disorder that most often results from a blood vessel touching a facial nerve. In hemifacial spasm, all of the muscles on one side of the face twitch involuntarily. Botox can provide symptom relief, but some patients require a neurosurgical procedure called microvascular decompression to treat the condition.
What causes eye twitching?
The most common causes of eyelid twitch are caffeine, fatigue, anxiety and stress. Eyelid twitch may appear in response to irritation caused by smoke, dust, or a foreign body in the eye. Allergies and infections may also cause irritation that leads to twitching.
Eyelid twitch may also be a symptom of neurologic disorders such as facial tics, chronic or transient motor tic disorders, attention-deficit disorder, or more serious conditions such as stroke, dystonia, tardive (slow or belated onset) dyskinesia, Tourette’s syndrome, or Aicardi syndrome (rare organic brain disorder acquired in early childhood).
Most common causes of eyelid twitch
Eyelid twitch is most often caused by mild, temporary conditions including:
- Anxiety: The increased stress associated with anxiety can be a contributing factor to eye twitch. When you’re anxious, you may tend to lose sleep, which increases fatigue around your whole body, including the muscles around your eye. If you’re experiencing additional symptoms such as restlessness, loss of sleep, trouble concentrating, or persistent worry, talk to your doctor about treatment for anxiety. By addressing the underlying condition, you can help relieve symptoms like eye twitching.
- Caffeine overuse: The caffeine in coffee, tea, chocolate and some sodas is a stimulant that can affect your eye muscles and lead to twitching. You may also turn to caffeine when you’re not well rested, which itself is a leading cause of eye twitch. To relieve eye twitch, cut back or eliminate caffeine from your diet and increase your sleep so you can feel more rested without depending on stimulants.
- Dry eye: When your eye loses moisture, it’s less able to wash away small particles that can irritate the eye. This increased irritation can trigger other eye symptoms such as eyelid twitching. You can help prevent digital eye strain by taking breaks from your computer screen to rest your eyes. Try the 20-20-20 rule: Every 20 minutes, look away from your screen at something 20 feet away for 20 seconds. This can help increase your blink rate and keep your eyes lubricated, reducing the chance of irritation that can lead to twitching.
- Fatigue: Whether physical or mental, fatigue and exhaustion can strain your eyes and the muscles surrounding them, leading to twitching. Again, lack of sleep is a primary culprit for this risk factor. If you have symptoms of poor sleep, including waking up often throughout the night, not feeling well rested in the morning, or getting sleepy throughout the day, talk to your doctor. Aside from minor symptoms like eye twitching, chronic loss of sleep can lead to complications such as sleep apnea and cognitive impairment. Your doctor or sleep medicine specialist can work with you to diagnose any underlying conditions and help establish good habits for better sleep.
- Irritants such as smoke or dust: Particles of smoke or dust can cause a variety of eye symptoms, including tearing, scratching and twitching. People with allergies may experience eye symptoms triggered by indoor allergens like dust mites or pet dander, or by outdoor allergens like pollen. Artificial irritants such as cigarette smoke or car exhaust can also cause eye symptoms including itching, redness or, in some cases, twitching. If you have chronically itchy, red or watery eyes, or if it frequently feels like there’s something in your eye, talk to your doctor about possible allergies. He or she can work with you on a treatment plan to reduce triggers and manage your symptoms.
- Stress: Stress is a broad term that can include acute stressful events, such as losing a job, or chronic stress that persists over time. In either case, experiencing stress can lead to a range of physical symptoms including a twitching eye. As with anxiety, stress often leads to decreased sleep quality, resulting in mental and physical fatigue that can strain the muscles around the eye. Stress may also push you to increase use of caffeine or alcohol, both of which can cause eye twitch. If you’re feeling overwhelmed or going through a stressful event, talk to your family doctor. He or she can address the physical symptoms of stress and recommend next steps for managing your mental health. By treating the underlying causes of your stress, you can help relieve symptoms like eye twitching.
- Vitamin and nutrient deficiency: Your body needs a balance of vitamins and nutrients to function properly. Electrically charged minerals known as electrolytes help control muscle action, including around the eye. An imbalance of electrolytes such as magnesium can result from dehydration and lead to muscle spasms, including eye twitch. A deficiency of vitamin B12 or vitamin D can also affect the bones and muscles and cause symptoms including eyelid twitching. Maintaining a healthy diet and drinking plenty of water can help keep your body’s vitamins and minerals at proper levels. If your eye twitch occurs with other symptoms such as vomiting, diarrhea, muscle weakness, or shaky movements, talk to your doctor about whether you may have an underlying condition causing a vitamin or mineral deficiency.
Ophthalmologic causes of eyelid twitch
Eyelid twitch can be caused by other conditions affecting the eye including:
- Blepharitis (inflammation of the eyelid margin)
- Conjunctivitis (inflammation of the eye surface)
- Corneal abrasion or ulcer (causes pain with blinking)
- Dry eyes
- Foreign body in the eye
- Primary congenital glaucoma
Neurologic causes of eyelid twitch
More persistent eyelid twitch, or twitching in which the eyelid completely closes, may be a symptom of a neurologic disorder including:
- Attention deficit disorder
- Blepharospasm (involuntary spasm or twitching of the eyelid)
- Chronic motor tic disorder
- Facial tic
- Tardive (slow or belated onset) dyskinesia
- Tourette’s syndrome
Serious or life-threatening causes of eyelid twitch
In more rare cases, eyelid twitch may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. These include:
- Aicardi syndrome (rare organic brain disorder acquired in early childhood)
- Seizure disorder
Is eye twitching a sign of multiple sclerosis (MS)?
Some patients with multiple sclerosis (MS) may experience eye twitching, and vision symptoms are often a first warning sign of the disease. However, experiencing only a mild, temporary eye twitch should not be cause for alarm. MS eye symptoms are more likely to include optic neuritis (inflammation of the optic nerve), which causes blurred, dimmed, or washed-out vision—or in some cases, complete vision loss. People with MS may also experience nystagmus (rapid, uncontrolled movement of the eyes) or diplopia (double vision).
Eye twitching can occur within the wide range of muscle spasms MS patients experience, but these symptoms most often appear in the limbs, specifically the legs.
How does stress cause eyelid twitch?
Stress is most often the cause of a temporary eye twitch, and doctors frequently recommend reducing stress or anxiety as a way to treat a twitching eye. During stressful times, you may be less likely to sleep well, which in turns leads to fatigue in the muscles around your eyes. Lack of sleep may also lead to increased caffeine or alcohol intake, another primary cause of eye twitch. If your stress is related to work, excessive time on your computer or phone can dry out your eyes and trigger twitching.
If stress is the likely culprit for your eye twitch, look for ways to relax your mind, improve your sleep, and cut back on stimulants like caffeine.
Why is my eye twitching while I’m pregnant?
Some pregnant women may notice eyelid twitching among their many pregnancy symptoms. As with other patients, this twitch is most often caused by stress, fatigue or exhaustion. Pregnancy is a stressful time, both physically and mentally, and sleep can become more difficult in later trimesters. In most cases a minor eyelid twitch is not cause for concern for a pregnant woman and can be treated by reducing stress and trying to get more rest.
However, drooping or paralysis around the eye can signal a more serious condition known as Bell’s palsy. While the specific cause of Bell’s palsy is not known, pregnant women are at higher risk of developing symptoms, which include inability to control facial muscles, loss of feeling, drooling, and inability to close the eye on the affected side of the face.
Bell’s palsy typically resolves on its own over time. But the lack of ability to routinely blink and fully close the eye on the paralyzed side of the face can lead to exposure of the eye and requires frequent lubrication to prevent damage to the corneal surface.
If you experience eye drooping or facial paralysis (during pregnancy or not), contact your doctor right away so he or she can rule out more serious neurological conditions.
Is eye twitching caused by a vitamin deficiency?
Maintaining a healthy diet helps keep your body’s vitamins and minerals at proper levels, which in turns helps keep various functions like muscle and nerve activity running smoothly. Electrically charged minerals known as electrolytes help control your muscles, including those around the eye. Dehydration can lead to an imbalance of electrolytes such as magnesium, potentially causing muscle spasms like eye twitch. Vitamin B12 and vitamin D also contribute to bone and muscle function, so a deficiency of either or both of these vitamins can cause movement symptoms including eyelid twitching.
If you experience additional symptoms such as muscle weakness, vomiting, diarrhea, or shaky movements with your eye twitch, talk to your doctor about whether you may have an underlying condition causing a vitamin or mineral deficiency and discuss the best way to find treatment.
What can you do to stop a twitching eye?
The most effective remedy for a twitching eye is often reducing stress or anxiety. Getting enough sleep can help prevent fatigue in the muscles around your eye, which can lead to twitching. If you’re rested, you’re also less likely to use stimulants like caffeine that can trigger eye twitch.
To relieve mild twitching eye symptoms, doctors recommend:
- Getting enough sleep
- Reducing stress
- Avoiding or limiting caffeine
- Minimizing alcohol use
- Treating symptoms of dry eye, which can cause irritation that leads to eye twitch
Certain prescription medications may also cause eyelid twitch as a side effect. If you’re on one or more prescriptions and experience eyelid twitching, talk to your doctor or pharmacist about whether your symptoms may be linked to a medication and discuss possible alternative treatments if needed.
For more serious eye spasms like blepharospasm or hemifacial spasm, doctors may recommend chemodenervation with botulinum toxin (Botox) injections or other medications. For severe spasms caused by nerve damage or compression, surgery may be necessary to treat the underlying condition.
How a doctor can help eyelid twitching
To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your eyelid twitch including:
- When did you first notice your eyelid twitching?
- Are your eyelid twitches constant, or do they come and go?
- Do you have any eye or eyelid pain?
- Do you have any other symptoms that involve your eyes?
- How much caffeine do you drink?
- Are you feeling stressed or anxious?
- Are you feeling tired?
- How much sleep do you get each night?
- Are you pregnant or possibly pregnant?
- Do you experience headaches or have you had a severe headache?
- Are you experiencing difficulty with speech?
- Are you experiencing difficulty with muscle coordination? Any muscle weakness?
- What medications are you taking?
- Do you take vitamins and/or supplements?
Your doctor can help you find ways to reduce risk factors for eyelid twitch like stress, fatigue or caffeine use. He or she can also discuss your family history and possible increased risk for neurological causes for your eyelid twitching. Finally, if you’re taking prescription medications that may cause a side effect of eyelid spasm, your doctor can advise on different treatment options if necessary.
What are the potential complications of eyelid twitch?
Once the underlying cause of eyelid twitch is diagnosed, it is important for you to follow your treatment plan to reduce the risk of potential complications including:
- Chronic eye irritation or pain
- Corneal abrasion, ulcer or scarring
- Loss of vision and blindness
While eyelid twitch itself is typically a minor symptom, it can result from a more significant underlying condition that could become serious without effective treatment.
Some conditions associated with eye twitch include:
- Anxiety: More than just the occasional “nerves,” anxiety disorder is a chronic condition that can disrupt your quality of life and become dangerous if left untreated. Talk to your doctor if your eye twitch is accompanied by symptoms including sleep problems, decreased sexual desire, chronic pain, or suicidal thoughts.
- Stress: Chronic or intense stress that goes without treatment can lead to serious complications and permanent emotional and physical damage, including conditions such as cardiovascular disease, gastrointestinal issues, sexual dysfunction, and substance abuse.
- Sleep disorders: Eye twitch is often a symptom of physical fatigue, which you may experience due to lack of quality sleep. Chronic sleep loss can lead to physical and emotional symptoms such as weight gain, cardiovascular disease, and depression. If you consistently wake up not feeling rested, or you feel sleepy throughout the day, you may have sleep apnea, a condition in which your breathing becomes interrupted during sleep, causing you to wake up (even if you don’t become fully conscious) several times a night. This can lead to complications including arrhythmia (irregular heartbeat), diabetes, high blood pressure, or stroke. See a sleep specialist for an accurate diagnosis and treatment of a sleep disorder.
If you experience any of these symptoms in addition to your eye twitching, talk to your doctor. By addressing your underlying conditions, reviewing your medical history, and discussing your individual risk factors, you can work together to find effective treatment and prevent further complications.