Eyelid twitching occurs as an involuntary muscle spasm in your eyelid muscle. It can affect the lower or upper eyelid or both eyelids at the same time.

Most cases of eyelid twitching are no more than a nuisance. The condition usually resolves itself over time. Treatment involves lifestyle changes to reduce stress and fatigue, as well as avoiding substances like caffeine and alcohol, that can worsen the condition.

Eyelid twitching can occur as the result of eye infections or other eye conditions, like pink eye (conjunctivitis). Occasionally, eyelid twitching is a sign of a more serious nervous system condition that demands medical care.

This article discusses the symptoms, causes, and treatment of eyelid twitching.

Symptoms of Eyelid Twitching

Eyelid twitching that occurs unrelated to a disorder or disease is called myokymia. It is defined by muscle spasms that make your eyelid quickly close or almost close continually and reopen.

This type of eyelid twitching is relatively common. It is often harmless and doesn't change normal vision. The condition usually fades without treatment.

Occasionally, eyelid twitching can occur as a result of serious conditions, which can result in slightly different symptoms.

Various conditions can cause eyelid twitching. They are outlined below.

Benign Essential Blepharospasm

Benign essential blepharospasm is a more severe form of eyelid twitching in which one or both eyelids close on their own. The spasms begin as increased blinking and grow more intense. It can leave you unable to open your eyes for a period of a few seconds to a few hours, leaving you blind.

Benign essential blepharospasm is caused by problems with nerve impulses linked to the basal ganglia. a group of structures deep within the brain. These nerve cell bodies help control all voluntary movements. As a result, the disease can also affect other muscles in your body.

Other symptoms of this condition include:

• Discomfort in the eyelids
• Dry eye
• Eyelid closure so tight you can't see
• Irritation of the eye's surface (cornea)
• Irritation of the membranes that line the eyelids due to pink eye (conjunctiva)
• Difficulty climbing stairs or driving a car
• Light sensitivity
  

Hemifacial Spasm

Hemifacial spasm is a neuromuscular disorder. The problem usually is related to a blood vessel pressing on a facial nerve.

Hemifacial spasm causes frequent, uncontrollable contractions or twitching of the facial muscles on one side of your face. In severe cases, a spasm can last as long as a few months.

The condition often begins with eyelid twitching, which can worsen and close the eye. It slowly spreads to include continuous muscle spasms in all the muscles of one side of the face.

Causes of Eyelid Twitching

Most harmless and self-correcting cases of eyelid twitching are related to lifestyle factors that can be changed.

The most common causes of harmless eyelid twitching include the following:

• Stress
• Fatigue or lack of sleep
• Caffeine, nicotine, and other stimulants

Stress and a lack of sleep can trigger muscle spasms in any part of your body, including your eyes. During these times, your body makes more adrenaline to prepare for a fight-or-flight reaction.

This elevated level of readiness requires longer periods of muscle activity. This can result in quick, intermittent muscle contractions that cause eye twitches.

Caffeine and the nicotine in tobacco can have a stimulant effect on your muscles and nerves. They also increase activity in your central nervous system to create heightened alertness and more energy.

Overuse of stimulants can interfere with the messages that tell your nervous system to rest. The result can cause an overload of muscle activity, leading to periodic muscle spasms.

What Medications Can Cause Eyelid Twitching

Eyelid twitching can occur as a side effect of Trokendi XR or Topamax (topiramate). This anticonvulsant drug is used to treat seizures that occur with epilepsy. It is also used to prevent migraine headaches.

How to Treat Eyelid Twitching

Eyelid twitching that is not related to a disease or disorder usually goes away without treatment. The following steps may help the twitching decrease faster:

• Reduce stress.
• Limit the amount of caffeine you consume.
• Avoid alcohol and tobacco products.
• Get more sleep.
• Apply a warm compress to the eye to relax the eye muscles.
• Use over-the-counter eye drops to reduce dryness.

Chronic eyelid twitching caused by benign essential blepharospasm or hemifacial spasms is usually treated with Botox, a brand of botulinum toxin.

Botox is injected under the skin around the eye, where it blocks the nerve signals that tell eyelid muscles to contract. This relaxes the muscles and prevents spasms. The effect lasts between three and 12 months.

Rarely, eyelid surgery called a protractor myectomy may be used to treat severe cases of benign essential blepharospasm. Microvascular decompression of the facial nerve may be used to treat hemifacial spasms.

Complications and Risk Factors Associated With Eyelid Twitching

Eyelid twitching is typically harmless to the physical structure of the eye since it only affects the eyelid. However, living with eyelid twitching can affect your quality of life and psychological well-being.

Some common complications linked to eyelid twitching include:

• Abnormal field of central vision due to lid closures
• Eye closure in extreme cases that causes temporary blindness
• Stress from living with a problem without a cause
• Inability to perform normal daily activities
  

You have a higher risk of eyelid twitching if you have any of the following characteristics:

• Living a high-stress lifestyle
• Using alcohol, caffeine, and/or tobacco excessively
• Getting inadequate nightly sleep
• Experiencing eye strain from computer, cell phone, or television use
• Taking topiramate
  

Are There Tests to Diagnose the Cause of Eyelid Twitching?

If you have symptoms of eyelid twitching without a known disorder, magnetic resonance imaging (MRI) of your brain may be used to rule out other conditions, including multiple sclerosis and a brain stem tumor. An MRI is also used to diagnose hemifacial spasms.

There is no laboratory test available to diagnose benign essential blepharospasm. Your healthcare provider makes a diagnosis based on your medical history, clinical examination, and symptoms.

When to See a Healthcare Provider

Contact your healthcare provider if you have eyelid twitching with any of the following characteristics:

• Eyelid twitching that lasts longer than one week
• Completely closed eyelid
• Twitching in other parts of your face
• Eye swelling, redness, or discharge
• Drooping upper eyelid
  

Summary

Eyelid twitching often occurs as harmless muscle spasms of your eyelids. Treatment usually isn't required. The problem often fixes itself within a few days.

You may be able to improve symptoms if you limit caffeine, alcohol, and tobacco. Reducing stress and getting the right amount of sleep can also help.

Rarely, eyelid twitching is linked to more severe problems like benign essential blepharospasm or hemifacial spasm. These ailments can cause more intense eyelid twitching and lead to eye closure. Botox injections can relax the treated eye muscles. This drug prevents the eye muscles from contracting.

A Word From Verywell

Living with eyelid twitching can be frustrating. While the problem is often harmless, it can be annoying and interfere with your quality of life. It can also be stressful if you're worried that your eyelid twitching is a sign of a more serious issue.

Start with a visit to your healthcare provider to get reassurance that your eyelid twitching isn't related to a disease. They can help you understand the cause of your problem.

Whether you're advised to reduce stress, improve sleep, or avoid alcohol, your healthcare provider can help you make these changes. Stay committed to your goals and you can have a better chance of avoiding eyelid twitching.