Eyelid twitch
Eyelid spasm; Eye twitch; Twitch - eyelid; Blepharospasm; Myokymia
An eyelid twitch is a general term for spasms of the eyelid muscles. These spasms happen without your control. The eyelid may repeatedly close (or nearly close) and reopen. This article discusses eyelid twitches in general.
The eye is the organ of sight, a nearly spherical hollow globe filled with fluids (humors). The outer layer or tunic (sclera, or white, and cornea) is fibrous and protective. The middle layer (choroid, ciliary body and the iris) is vascular. The innermost layer (the retina) is nervous or sensory. The fluids in the eye are divided by the lens into the vitreous humor (behind the lens) and the aqueous humor (in front of the lens). The lens itself is flexible and suspended by ligaments which allow it to change shape to focus light on the retina, which is composed of sensory neurons.
The orbicularis occuli muscles circle the eyes and are located just under the skin. Parts of this muscle act to open and close the eyelids and are important muscles in facial expression.
Causes
The most common things that make the muscle in your eyelid twitch are fatigue, stress, caffeine, and excessive alcohol intake. Rarely, they can be a side effect of a medicine used for migraine headaches. Once spasms begin, they may continue off and on for a few days. Then, they disappear. Most people have this type of eyelid twitch once in a while and find it very annoying. In most cases, you won't even notice when the twitch has stopped.
You may have more severe contractions, where the eyelid completely closes. This form of eyelid twitching is called blepharospasm. It lasts much longer than the more common type of eyelid twitch. It is often very uncomfortable and may cause your eyelids to close completely. Twitching can be caused by irritation of the:
- Surface of the eye (cornea)
- Membranes lining the eyelids (conjunctiva)
Sometimes, the reason your eyelid is twitching cannot be found.
Symptoms
Common symptoms of eyelid twitch are:
- Repeated uncontrollable twitching or spasms of your eyelid (most often the upper lid)
- Light sensitivity (sometimes, this is the cause of the twitching)
- Blurry vision (sometimes)
Treatment
Eyelid twitching most often goes away without treatment. In the meantime, the following steps may help:
- Get more sleep.
- Drink less caffeine.
- Consume less alcohol.
- Lubricate your eyes with eye drops.
If twitching is severe or lasts a long time, small injections of botulinum toxin can control the spasms. In rare cases of severe blepharospasm, limited removal of some of the muscles around the eyelids or brain surgery may be helpful.
Outlook (Prognosis)
The outlook depends on the specific type or cause of eyelid twitch. In most cases, the twitches stop within a week.
Possible Complications
There could be some loss of vision if the eyelid twitch is due to an undetected injury. This occurs rarely.
When to Contact a Medical Professional
Contact your primary care doctor or eye doctor (ophthalmologist or optometrist) if:
- Eyelid twitching does not go away within 1 week
- Twitching completely closes your eyelid
- Twitching involves other parts of your face
- You have redness, swelling, or a discharge from your eye
- Your upper eyelid is drooping
References
Cioffi GA, Liebmann JM. Diseases of the visual system. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 395.
Luthra NS, Mitchell KT, Volz MM, Tamir I, Starr PA, Ostrem JL. Intractable blepharospasm treated with bilateral pallidal deep brain stimulation. Tremor Other Hyperkinet Mov (N Y). 2017;7:472. PMID: 28975046
Phillips LT, Friedman DI. Disorders of the neuromuscular junction. In: Yanoff M, Duker JS, eds. Ophthalmology. 5th ed. Philadelphia, PA: Elsevier; 2019:chap 9.17.
Salmon JF. Neuro-ophthalmology. In: Salmon JF, ed. Kanski's Clinical Ophthalmology. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 19.
Thurtell MJ, Rucker JC. Pupillary and eyelid abnormalities. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 17.
Version Info
Last reviewed on: 8/22/2022
Reviewed by: Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
