When Is Eye Twitching a Sign of Something Serious?

Reviewed on 12/16/2021

Eye twitching is usually not a serious concern. See a doctor if it lasts longer than one week, eye inflammation/irritation/redness/swelling/eye discharge, new or additional symptoms occur (other facial spasms), difficulty opening the eye, twitching occurs in other parts of the body, or the eyelids begin to droop.
Eye twitching is usually not a serious concern. See a doctor if it lasts longer than one week, eye inflammation/irritation/redness/swelling/eye discharge, new or additional symptoms occur (other facial spasms), difficulty opening the eye, twitching occurs in other parts of the body, or the eyelids begin to droop.

Eye twitching (blepharospasm) is an abnormal, involuntary blinking or spasm of the eyelids.

Most of the time eye twitching is not a cause for worry and is due to conditions that go way on their own, but sometimes twitches can be a sign of a problem with the nervous system

The cause of eye twitching is not known but it is believed to be due to an abnormal function of the part of the brain responsible for controlling muscles (the basal ganglia). 

Rarely, genetics may play a role in the development of blepharospasm.

Benign essential blepharospasm (BEB) is a form of eye twitching that is a progressive neurological disorder. 

See a doctor if you have eye twitching and: 

  • Eye twitching lasts longer than one week
  • Eye inflammation, irritation, redness, swelling, or eye discharge
  • New or additional symptoms occur, such as other facial spasms 
  • You have difficulty opening the eye
  • Twitching occurs in other parts of the body
  • The eyelids begin to droop

What Are the Symptoms of Eye Twitching?

Symptoms of eye twitching (blepharospasm) usually do not cause pain and can include: 

  • Spasm of the eyelids
  • Involuntary eyelid closure
  • Increased blinking
  • Sensitivity to bright light
  • Eye irritation
  • Fatigue
  • Emotional tension
  • Symptoms become more frequent as the condition progresses in benign essential blepharospasm (BEB)
  • Facial spasms may develop in BEB

What Is the Treatment for Eye Twitching?

Less serious and often temporary causes of eye twitching often do not require treatment, and twitching will usually go away on its own. When treatment is needed, it depends on the cause may include:

  • Consumption of caffeine or other stimulants
    • Reduce or avoid caffeine or stimulant use 
  • Lack of sleep
    • Maintain good hygiene and get adequate sleep
  • Nicotine from smoking and tobacco use
    • Don’t smoke or use tobacco
  • Stress or anxiety (“nervous ticks”)
    • Practice stress reduction techniques such as mediation, deep breathing, or yoga
  • Eye irritation or dryness 
    • If there is no underlying medical condition causing eye irritation or dryness, lubricating eye drops may help
  • Dehydration
    • Increase water intake
  • Physical activity due to:
    • Accumulation of lactic acid (lactic acidosis) 
      • Reduce intensity or duration of exercise
      • Get adequate fluid intake 
      • Rest
    • Electrolyte deficiency
      • Drink enough water while exercising
      • Consume coconut water or sports drinks with electrolytes
  • Nutrient deficiencies such as vitamin D, vitamin B, and calcium
  • Side effects of medications 
    • Talk to your doctor about changing to another medication that may not cause the eye twitching (do not stop taking any medications without first talking to your doctor)

There is no cure for benign essential blepharospasm (BEB) but there are some treatments that can reduce its severity, such as:

  • Oculinum (botulinum toxin, or Botox) injection into the muscles of the eyelids 
  • Medications 
    • Medicines are only helpful in about 15% of cases
    • Symptom relief is usually short term 
    • Medications used may include:
      • Antiarrhythmics
      • Anticholinergics
      • Anticonvulsants
      • Atypical antipsychotics
      • Benzodiazepines
      • Dopamine receptor agonists
      • GABAB receptor agonists
      • Imidazopyridines
      • Monoamine depleters
      • Neuroleptics
      • Serotonin receptor antagonists
  • Surgery
    • Myectomy: removes some of the muscles and nerves of the eyelids and improves symptoms in 75 to 85 percent of patients
  • Alternative therapies (not proven)
    • Acupuncture
    • Biofeedback
    • Chiropractic
    • Hypnosis
    • Nutritional therapy

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Reviewed on 12/16/2021
References
Image Source: iStock Images

https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/blepharospasm

https://www.blepharospasm.org/blepharospasm-oral-medications1.html

https://www.cedars-sinai.org/health-library/diseases-and-conditions/e/eye-twitching.html