Twitching Eye: Causes and Treatments

Twitching eyes are a very common problem, and one that many patients experience. It can vary from mildly annoying to completely distracting, and if severe enough, can cause the eye to spasm shut, causing inability to use the eye for a short time. The medical term for twitching eyelids is ‘blepharospasm’, meaning contraction of the muscles of the eyelid. It can involve the upper lid, the lower lid, or both eyelids, and even the muscles of the forehead and face. At times, it is so mild that it cannot be seen by anyone, but is felt by the patient. In other cases, it is clearly visible to people looking at the patient.

What are the causes of blepharospasm?

Most of the time, the cause of twitching is unknown. Dr. Goldstein always asks his patients certain ‘lifestyle’ questions to try and figure out if there is a controllable cause for the twitching.

• Stress Almost everyone has some stress in their lives, but if the stress is particularly bad, it may be the cause of the twitch.
• Fatigue Lack of sleep will often lead to spasms of the eyelid muscles, just due to the increased level of stress hormones in the body.
• Caffeine Caffeine, by its nature, is a stimulant, and can cause random firing of nerves and muscle cells.
• All of the above People who are under stress tend not to sleep well. To combat the resulting fatigue, they drink more caffeine, and a vicious circle ensues. Stress leads to lack of sleep, lack of sleep leads to caffeine overuse, which causes it to be more difficult to sleep!

How is blepharospasm treated?

Twitching usually resolves on its own, although it can take weeks to do so. There are some suggested treatments listed below:

• Decrease or eliminate caffeine Caffeine is a strong stimulant, found in coffee, tea, soda pop, and energy drinks. Limit intake, especially during times of stress.
• Sleep more Getting a good night’s sleep is very important. Decreasing caffeine will help. Eating meals a little earlier, and reading in bed all help promote sleep.
• Decrease or eliminate stress Often easier said than done, stress management is probably the most important aspect of treating this problem. Changing the stressful situations in life may not be easy, so alternatives may be helpful. Anecdotally, increasing water and tonic water intake may help. Yoga, meditation and breathing techniques may be helpful.
• Medical treatment It is very unlikely that blepharospasm will become a long-term problem. If it does not resolve, then Botox may be used to stop the twitch. Unfortunately, it usually needs to be repeated every 3-6 months.