Introduction  

An eyelid twitch is an involuntary and repetitive spasm on the eyelid muscles. It is when a person’s eyelid rapidly moves a little. It usually affects the upper lid but can also occur in both lids. In most cases, these spasms are mild gentle tugs on the eyelid. These spasms come and go but in some cases they can last for several weeks. A persistent eyelid twitch could signal a neurological condition of the eyelid and needs to be treated immediately

Also Known As

  • Myokymia
  • Eyelid tic
     

Sub-Types

  • Benign essential blepharospasm - It begins with increased blinking on both eyes and may end with the eyelids being squeezed shut. This may last somewhere between some seconds to a few hours. When it begins, a person might wink, pinch up their face, or blink. These spasms can affect other facial muscles. In severe cases, a person may be unable to perform general tasks like walking up the stairs, driving their car, or even going to work. This condition is caused by a nerve impulse.
  • Hemifacial spasm - Here, twitches affect the muscles on one side of the face. The affected person’s face tightens up. In serious cases, the condition could last a few months.

A hemifacial spasm arises when a blood vessel presses upon a facial nerve.

Causes and Risk Factors

In some cases, eyelid spasms occur without an identifiable cause. However, those who are most at risk of getting eyelid twitches include:

  • Individuals who are fatigued or under stress
  • People who smoke or consume alcohol
  • People with eye irritation
  • People who are straining their eyes
     

Signs & Symptoms

The following are the symptoms of eyelid spasms:

  • Eye irritation
  • Light sensitivity
  • Tension/fatigue
  • Involuntary eye muscle movement
  • Repetitive blinking of the eyes
     

Diagnosis

The eye care professional can diagnose an eyelid spasm by:

  • Taking the patient’s history if the condition keeps recurring
  • Conducting an eye test to determine whether there is any irritation or sensitivity
  • Determining whether the eye is swollen or the patient has difficulty opening the eyelids
     

Treatment 

Treatment of eyelid spasms is directed towards stopping the repetitive and involuntary movement of the eyelid muscles.

Medical Treatment

In most cases, eyelid spasms stop within a few days without treatment. If they don’t, the eye doctor may recommend botulinum toxin (Botox) shots. Botox treatment helps the muscles to relax. Using a needle, the doctor will inject the treatment into the muscles in the eye. The spasms will start to disappear in a matter of days.

Surgical Treatment

Surgery is used when Botox injections fail to work. The aim of surgery is to remove the muscles that are causing spasms. This treatment may also be used to remove nerves in the eyelids to make the twitching less severe.

Alternative Treatment

 

Prognosis/Long-term outlook

Eyelid spasms are rarely a sign of a serious nerve or brain disorder. But, when they are caused by these conditions, they are accompanied by severe symptoms. Some of the nerve and brain disorders that cause eyelid spasms include:

  • Bell’s palsy – A condition where one side of the patient’s face droops downward
  • Dystonia – A condition characterized by unexpected muscle spasms
  • Cervical dystonia – A condition where the patient experiences neck spasms and their head twists into different positions
  • Parkinson’s disease – A condition where the patient has muscle stiffness, balance problems, trembling limbs and difficulty speaking
  • Multiple sclerosis (MS) – A condition that causes movement and cognitive problems
  • Tourette syndrome – A condition characterized by verbal tics and involuntary movement
  • Corneal scratches – These are scratches on the cornea (a transparent dome that covers the eye’s iris and pupil)

Eyelid spasms can be triggered by many factors. Effectiveness of the treatment and the outlook will depend on the patient. Twitches have no link to genetics. Twitches caused by lack of sleep, stress, and other related lifestyle factors usually have the best outlook. If eyelid spasms are caused by a health condition, treating this condition is the best way to relieve the twitching.
 

Prevention/Follow Up

If a person is experiencing regular spasms, they should maintain a journal and note how they are triggered. They should also watch their intake of alcohol, tobacco, and caffeine. It is also important to look into stress levels and how much sleep they are getting.

Generally, avoiding too much alcohol, tobacco, and caffeine can help prevent eyelid spasms. Additionally, getting enough sleep and avoiding stressing factors can help prevent eye twitching.