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What is eye twitching, or eyelid myokymia?

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Author : Dr Deepak Garg
Eyelid Muscle twitching

Eye twitching, or eyelid myokymia in medical terms, is an involuntary and abnormal blinking of the eyelids, predominantly affecting the upper eyelid. This phenomenon is also known as eyelid spasm due to the involvement of certain muscles. These eyelid twitches can occur multiple times throughout the day and typically last for a few minutes. There are two sets of muscles responsible for opening and closing the eyelids. The lower lid is controlled by one of the facial muscles known as the orbicularis oculi, while the upper eyelid is managed by a muscle called the levator palpebrae superioris(LPS). Most commonly, the twitching is experienced in the LPS muscle, which is the upper eyelid. While it can affect individuals of all age groups, it is commonly observed in middle-aged and older individuals, with no particular gender predisposition.

What causes eye twitching?

Eye twitching is generally benign and does not lead to any serious medical conditions. However, it can serve as one of the signs of more concerning issues. The common causes of eyelid twitching are described below:

  1. Fatigue: This applies to almost all the muscles in the body. When our body experiences extreme exhaustion, it can create an imbalance in the electrolytes that regulate muscle movement, leading to short bouts of spasms and eye twitching. Lack of sleep can also be a contributing factor. Ensuring a good night’s sleep, ideally 7-8 hours, can significantly reduce the occurrence of eye twitching.
  1. Dehydration: Inadequate water intake can lead to an electrolyte imbalance, which may result in eyelid twitching.
  1. Stress: Stress triggers the release of a hormone called cortisol in our bodies. Cortisol is a natural steroid and a stimulant. This is why, when we’re stressed, we often struggle to sleep and may suffer from chronic insomnia. Prolonged exposure to excessive cortisol levels in our systems can lead to muscle spasms, including eyelid twitching. Therefore, incorporating stress management activities like meditation, yoga, and breathing exercises can help reduce the frequency of eye twitching.
  1. Excessive Caffeine Consumption: Caffeine is a stimulant for the nervous system. Instead of promoting rest and sleep, it can keep you awake and alert, leading to inadequate sleep. This lack of sleep can contribute to eyelid twitching. Reducing your caffeine intake can be a straightforward way to alleviate the occurrence of eye twitching.

Types of Eyelid Twitching

  • Benign Essential Blepharospasm: Also known as essential blepharospasm, this is a neurological condition that causes involuntary twitching and even closure of the eyelids. It results from dystonia in the affected eyelid muscle, leading to the loss of normal muscle tone and involuntary twitching. Symptoms of benign essential blepharospasm include light sensitivity, eye irritation, difficulty keeping the eyes open, and frequent, involuntary blinking.
  • Dryness of the Eyes: Individuals who spend excessive time in front of screens are prone to dry eyes. The tear film is not only essential for a smooth ocular surface but also for the smooth movement of the eyelids. Dry eyes can disrupt this smoothness and lead to muscle spasms. Eye strain caused by dryness can contribute to twitching. The easiest treatment for dryness is using artificial tears to keep the eye surface moist. This is the most common type of eyelid twitching.
  • Hemifacial Spasms: This is a severe form of a nervous system disorder that not only causes eyelid spasms but also facial spasms on the affected side of the face. In this condition, the facial nerve that controls the muscles of the face is affected, resulting in involuntary contractions of the facial muscles, including eyelid myokymia. Common causes of hemifacial spasms include blood vessels interfering with the facial nerve, anxiety, stress, and fatigue.

Eye Twitching Treatment

Usually, eyelid twitching does not require any medical treatment and tends to subside on its own. However, it is often associated with eyestrain and eye fatigue. The American Academy of Ophthalmology and the American Academy of Optometry recommend following the 20-20-20 rule, which involves taking breaks while using screens at close range by looking at least 20 feet away and blinking 20 times every 20 minutes. In some cases, eyelid twitching can be a precursor symptom of certain health conditions that lead to end-of-day fatigue, such as myasthenia gravis. If the twitching persists for extended periods, seeking an eye doctor’s opinion is a prudent step.

The American Academy of Ophthalmology has investigated the role of Botox injections in alleviating eyelid twitching. In severe cases of dystonia affecting eyelid muscles, these neurotoxin injections can help relax the muscles and prevent eyelid twitching.

Applying a warm compress over the twitching eyelid can also alleviate symptoms. The heat dilates the blood vessels supplying the eyelid muscles, relaxing the muscles and preventing spasms.

When should I see a doctor about my eye twitching

Chronic eyelid twitching that lasts for more than a few days or increases in frequency and severity requires medical attention. If you experience a strong, involuntary spasm making it difficult to keep your eyelids open, it also necessitates medical attention. Other indications to visit your eye doctor include:

  • Twitching that occurs elsewhere in the body or face.
  • Increased sensitivity to light.
  • Eyelid swelling.
  • Inflamed eyelids.
  • Redness with associated discharge from the eye.
  • Sudden blurred or decreased vision.

Eyelid twitching may be a symptom of an underlying condition that requires treatment. In some cases, a minor eyelid twitch can help your healthcare provider diagnose a serious underlying condition. If eyelid twitching persists despite making necessary lifestyle modifications, it is essential to consult an eye care practitioner.

Frequently Asked Questions

1. Why is my eye continuously twitching?

Eyelid twitching is often associated with increased stress and dehydration. Incorporating stress-relief strategies and improving fluid intake can help reduce eye twitching.

2. How can I stop my eye twitch?

Eye twitching can have various causes, with common ones being increased caffeine intake, lack of sleep, or underlying medical conditions. It’s advisable to address these issues after consulting with your eye doctor.

3. When is an eye twitch a sign of something more serious?

Chronic eyelid twitching that lasts for more than a few days or increases in frequency and severity requires medical attention. If you experience strong, involuntary spasms that make it difficult to keep your eyelids open, seeking medical attention is essential.

4. Can eye twitching be caused by stress?

Yes, studies have shown that stress triggers the release of cortisol, a hormone that acts similarly to caffeine and stimulates the nervous system. This is why eye twitching often occurs during high-stress periods.

5. When should I be concerned about eye twitching and headaches?

If eyelid twitching is associated with twitching elsewhere in the body or particularly in the face, seeking medical attention is necessary.

6. What is an eye twitch a symptom of?

Minor eye twitching is usually harmless, but a forceful, involuntary spasm can be a symptom of an underlying neurological condition.

7. Can hormones cause eye twitching?

The most common hormone linked to eye twitching is cortisol, which is released during high-stress periods.

8. What is the remedy for eye twitching?

Treatment for eyelid twitching depends on its cause. From an ophthalmological perspective, when no other symptoms are present, the initial treatment may include artificial tears and warm compresses, along with lifestyle modifications to reduce stress. If the twitching persists for more than a few days, seek timely medical attention.

9. How long does eye twitching last?

Eye twitching typically lasts no more than a week, and each time you experience it, it lasts for a few seconds to a few minutes.

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