Eye Twitching " Myokinesia"

eye twitching
Eye twitch is the repetitive, involuntary spasm of eyelid muscles. It comes on suddenly and can last for a second,  minute, hours, days or even longer. While it may feel as if everyone can see the twitch, most twitches are slight enough that they can’t be seen by someone simply looking at your face.

Eye spasm or twitch usually occurs in the upper lid, but can occur in both the upper and lower lid. These movements are unpredictable, painless, harmless,  does not affect vision and resolves on its own but it bothers the patient. Mostly, these spasms are very mild and feel like a gentle tug on the eyelid. However, there are some neurological problems that can make eyelid muscles contracts, such as blepharospasm and hemifacial spasm. These less common conditions generally tend to cause the eyelids to close more fully and for longer periods of time, limiting or completely blocking vision.   Another condition known as hemifacial spasm exists, wherein an involuntary twitching on one whole side of the face occurs, caused by compression of one of the facial nerve.Other muscles in the face may be affected as well.

Eyelid twitching may be triggered by:

  • Alcohol intake
  • Bright light
  • Caffeine excess
  • Fatigue
  • Irritation of the eye surface or inner eyelids
  • Lack of sleep
  • Medication
  • Physical exertion
  • Smoking
  • Stress
  • Wind

Other conditions that sometimes include eyelid twitching as a sign include

  • Corneal abrasion
  • Conjunctivitis
  • Dry eyes
  • Entropion
  • Light sensitivity
  • Trichiasis 
twitching of eye

Very rarely, eye twitching may be a sign of certain brain and nervous system disorders. When it is, it's almost always accompanied by other signs and symptoms. Brain and nervous system disorders that can cause eye twitching include:
  • Bells palsy
  • Cervical dystonia
  • Dystonia
  • Multiple sclerosis
  • Oromandibular dystonia and facial dystonia
  • Tourette syndrome
Eye twitching may be a side effect of drugs, particularly medication used to treat epilepsy and psychosis. And eye twitching is sometimes the earliest sign of a chronic movement disorder, especially if other facial spasms develop too.

For the majority, the common eyelid twitch is a brief and minor irritant.  But when it lasts longer or occurs more frequently than usual, there are some tips to reduce the effect.

1. Get some rest

Eyelid twitches often happen to people when they are overly tired. Get some restorative sleep.

2. Reduce  stress

Being under stress can lead to a twitch. Stress is regarded as number 1 cause of eye spasm by various studies. If you can’t eliminate something causing you stress, find stress-reducing activities to help get rid of the twitch.

3. Drink less caffeine

As a stimulant, caffeine can cause eyelid spasms. Limiting your coffee, tea or soda intake may help to reduce eyelid twitching.

4. Moisturize the eyes

In some cases, having irritated or dry eyes can lead to eyelid spasms. Use of artificial tears can reduce grittiness and twitching.

5. Massage

Giving a gentle massage to eye with warm compression in between can help reduce the spasm.

Usually, no treatment is required for such tics but one needs to see the ophthalmologist if following events occur.

1. Eyes are red, swollen with discharge.
2. Eyelids get drooped.
3. Eyelid gets completely closed with each twitch or there is difficulty opening the eye.
4. Continues for several weeks.
5. Involves other parts of a face.

About the author: Dr. Monica Karmachary is medical director at Dibyajyoti eye/ear care hospital, Eastern Nepal.

1. www.mayoclinic.org
2. www.aao.org