EYE TWITCHING

Eye twitching (blepharospasm) is an involuntary movement of the eyelid every few seconds over the course of a minute or two. Sometimes the spasm is strong enough to make your eyelid close completely before reopening.

Some of the causes of eyelid spasms that have been identified include:

  • Alcohol intake
  • Bright lights
  • Caffeine intake
  • Fatigue
  • Irritation of the eye surface or inner eyelids
  • Lack of sleep
  • Smoking
  • Stress
  • Wind

Sometimes, eye twitching may be the earliest sign of a chronic movement disorder, especially if other facial spasms develop in addition to the eye twitching. Usually, however, there is no identifiable cause.

There are three common types of eye twitch:

  • Minor eyelid twitch also can be caused by irritation of the surface of the eye (cornea) or the membranes lining the eyelids (conjunctiva). Sometimes the cause of minor eyelid twitch cannot be identified. In almost all cases it is painless and harmless.
  • Benign essential blepharospasm usually develops in mid- to late-adulthood and gradually worsens. It’s twice as common in women as in men. It is not a serious condition but can interfere with your daily life in more severe cases.
  • Hemifacial spasm is quite rare and involves more than just the eyelid muscles. It also usually involves the muscles around the mouth. Unlike other types of eyelid twitching, it usually affects only one side of the face.

DIAGNOSIS

You should see an eye doctor if you have:

  • Twitching that persists for more than one week
  • Twitching that completely closes an eyelid
  • Spasms that involve other facial muscles
  • Redness, swelling, or discharge from an eye
  • A drooping upper eyelid

If your doctor suspects that a brain or nerve disorder is responsible for eye twitching, he or she will examine you for other common signs. You may be referred to a neurologist or other specialist.

 

RECOMMENDED MEDICATIONS

In most cases, minor eyelid twitch will disappear without you even noticing if you get enough rest and/or reduce or eliminate your intake of alcohol, tobacco, or caffeine. Blepharospasm does not occur while sleeping.

If you have dry eyes causing irritation of the cornea or conjunctiva, treating it with over-the-counter artificial tears will often relieve minor eyelid twitch.

So far, doctors have not found a successful cure for benign essential blepharospasm. But several treatment options may reduce its severity.

The most commonly recommended treatment for benign essential blepharospasm is botulinum toxin (also known as Botox or Xeomin). It’s approved for this use in both the U.S. and Canada. Botox is also commonly recommended for patients with hemifacial spasm.

When injected in very small quantities into the eye muscles, the drug may relieve spasms for several months. But the effect gradually wears off. Repeat injections are usually necessary.

In mild cases of benign essential blepharospasm, doctors sometimes recommend medications such as:

  • Clonazepam
  • Lorazepam
  • Trihexyphenidyl

These usually provide only short-term relief and have been found to help in only about 15% of cases.  Alternative treatments for benign essential blepharospasm include:

  • Biofeedback
  • Acupuncture
  • Hypnosis
  • Chiropractic
  • Nutrition therapy

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