What is eye twitching?

An eye twitch is an involuntary, abnormal blinking of your eyelid. This abnormal blinking may happen many times per day. If eye twitching is severe, it can affect your vision.

One facial muscle closes your eyelid. Another raises your eyelid. Problems with either of these muscles (and sometimes both) may cause your eye to twitch. Other eye muscles also may contribute to eye twitching.

Many people have an occasional eye twitch, especially when they are tired or have had a lot of caffeine. Frequent eye twitching is fairly uncommon. Anyone can have eye twitching, but it is more common in middle-aged and older women.

What causes eye twitching?

Many things that irritate the eye can cause eyelid twitching. This includes inflammation or infections of the eye or even a dirty contact lens.

A common cause of eyelid twitching is ocular myokymia. This is benign and does not lead to other problems. Ocular myokymia can be caused by being tired, having too much caffeine, or stress. Chronic eyelid myokymia is more common in women and associated with cold weather.

One cause of persistent, frequent eye twitching is a condition called benign essential blepharospasm. This is when both eyes close or twitch at the same time. Researchers aren’t sure exactly what causes it, but it can cause problems with the muscle groups around your eye. They also think problems with the basal ganglia (a part of the brain) might play a role. Having certain genes may contribute to eye twitching in some people too.

Rarely, another problem with the brain or nervous system might cause eye twitching. These problems include:

• Parkinson disease

• Brain damage from inflammation or a stroke. This is especially true for the thalamus, basal ganglia, or brain stem.

• Reaction to certain mental health medicines

• Meige syndrome. This is a nervous system movement disorder.

• Multiple sclerosis

• Hemifacial spasm

• Bell palsy

These health conditions usually have other symptoms as well.

Who is at risk for eye twitching?

A history of head injury may increase your risk for eye twitching. You may also be at greater risk if it runs in your family, or if you have used certain mental health medicines.

What are the symptoms of eye twitching?

Eyelid twitches vary quite a bit in severity and frequency. Some people might have eyelid twitches every few seconds. Others might have them much less often. Your eye twitches may last for a few days or longer and then go away for a while. In some people, eye twitching happens more often and lasts longer over time. In many others, symptoms go away and don’t come back.

Usually, only the upper lid twitches. Probably both of your eyes will twitch, but sometimes only one eye shows symptoms. Your eyelid might just shut partly, or it might close all the way.

In addition to eyelid spasms, you might note these symptoms:

• Eye irritation (often a first symptom)

• Increased rate of blinking

• Light sensitivity

• Dry eyes

• Vision problems, if twitching is frequent

• Facial spasms

Symptoms of eye twitching often go away when you are sleeping or concentrating on a difficult task. Many people find that certain tasks may make their eye twitching go away briefly. This might be activities such as talking, singing, or touching another part of the body.

Other things may make symptoms more likely. These include:

• Tiredness (fatigue)

• Stress

• Bright lights

• Driving

• Caffeine

• Eye irritation from another cause

How is eye twitching diagnosed?

Your healthcare provider will ask about your health history and do a physical exam. This often includes a full nervous system and eye exam. Often, a healthcare provider who specializes in the eyes (ophthalmologist) will make the diagnosis. Your provider may need home videos to see what the twitching looks like if it doesn't happen in the office. If your provider rules out other causes of eye twitch, they may diagnose you with benign essential blepharospasm or hemifacial spasm. You often won’t need any other tests. In some cases, your provider might order imaging of your brain with a CT scan or an MRI. This can rule out other medical causes of eye twitch.

How is eye twitching treated?

You might not need any treatment if you don’t have a lot of symptoms from eye twitching. Getting more rest and reducing your caffeine intake might help ease your symptoms.

If your eye twitching is causing problems, your healthcare provider might recommend a botulinum toxin injection into the muscles of your eyelids. This may paralyze the muscle that is contracting.

Your healthcare provider might have you try a medicine to treat eye twitching. These medicines tend to ease symptoms only in the short term. They don’t help everyone.

If your eye twitching is still bad, you may need a surgery called a myectomy. In this surgery, healthcare providers remove some of the muscles and nerves of your eyelids. This stops symptoms in many people.

Your healthcare provider will also need to treat any underlying health conditions that might be causing your eye twitching. An example is Parkinson disease.

What are possible complications of eye twitching?

If eye twitching is chronic and severe, it can permanently damage your eyelids and the other structures in the area. This can cause problems, such as:

• Upper eyelids resting lower than normal

• Eyebrows resting lower than normal

• Extra skin in the upper or lower eye

• Abnormal folding in of the eyelids

Some people with chronic eye twitching also eventually develop muscle spasms in other parts of the body, such as the jaw or neck.

How to manage eye twitching

If your eyes sometimes twitch, you can take steps to reduce your symptoms:

• Don't have caffeine.

• Get enough sleep.

• Reduce stress.

• Reduce other sources of eye irritation. This might be by using eye drops.

• Use sunglasses when needed.

When should I call my healthcare provider?

Call your healthcare provider if your eye twitching lasts longer than a week. Also call if you have new or additional symptoms, such as other facial spasms or discharge from your eye.

Key points about eye twitching

• An eye twitch is an involuntary, abnormal blinking of your eyelid. If your eye twitching is frequent, it may affect your vision.

• Occasional eye twitches are common. If you have eye twitches more often, you may have a condition called benign essential blepharospasm.

• In rare instances, eye twitching is from an underlying health condition.

• Bright lights, stress, fatigue, caffeine, and eye irritation may make symptoms of eye twitching worse.

• You might not need any treatment for your eye twitching. Or you might need botulinum toxin treatments on your eye muscles. You also might eventually need surgery.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions, especially after office hours or on weekends.