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Eyelid spasm or twitching is a repetitive, sporadic, and involuntary movement.

Although it is a benign and very common condition, many people find it bothersome. We will look into what its main causes are and how to prevent it.

This condition is commonly referred to as eyelid twitching, but it can also be called myokymia or blepharospasm. It is an involuntary, repetitive contraction of the orbicularis oculi muscle, which surrounds the eye.

There are three common types of eyelid twitching or blepharospasm:

• Benign essential blepharospasm: This condition usually affects both eyes, causing chronic, intense, involuntary blinking.
• Hemifacial spasm: A condition that only affects the muscles on one side of the face.
  
• Minor eye twitch, nervous contraction, or tic: A minor contraction of the eyelid. It rarely requires treatment and usually resolves spontaneously.

People with these contractions say that they are usually mild and feel like a slight jerk of the eyelid. It can occur every few seconds for a couple of minutes.

These episodes appear unpredictably: they can be constant throughout the day or go away for weeks or months.

Most cases of eyelid twitching resolve without treatment. It is rarely a warning sign of a chronic movement disorder or health problem.

Why does the eyelid twitch?

Since eyelid twitching is rarely a sign of a serious problem, its causes are usually not investigated and it is expected to go away on its own.

However, some factors have been reported to be related to the onset of eyelid twitching:

• Blepharitis (swelling of the eyelid).
• Conjunctivitis.
• Excessive alcohol, caffeine, or tobacco consumption.
• Eyelid drooping.
• Side effects of certain medications, especially antihistamines and antidepressants.
• Stress.
• Exposure to environmental irritants, such as sunlight, artificial light, dust, or wind.
  
• Lack of sleep.
• Fatigue.
  
• Eye irritation.
• Dry eyes.
• Scratching.
• Sensitivity to light.
• Physical overexertion.

Involuntary blinking can also be related to:

• Central nervous system alterations.
• Concussion.
• Dystonia.
• Multiple sclerosis.
• Parkinson’s disease.
• Bell’s palsy (facial paralysis).
• Meige syndrome.
• Tourette syndrome.

While this condition is usually benign, it can persist or worsen over time and cause facial spasms, sensitivity to light, and blurry vision.

How to prevent eyelid twitching

Although involuntary twitching usually disappears with time, if it doesn’t it can be very bothersome and require professional help.

The treatment depends on what caused the eyelid to twitch or spasm. A doctor can make a diagnosis and give various recommendations:

• Drink less caffeine, whether it’s coffee, tea, or energy drinks.
• Get enough sleep and have a regular sleep schedule.
• Keep your eyes lubricated with over-the-counter or prescription artificial tears or eye drops.
• Get botulinum toxin (Botox) injections. These are often used to treat benign essential blepharospasm. Over time, the effects of the injection go away and you may need to have more injections.
  
• Reduce alcohol and tobacco consumption.
• Apply warm compresses on the eyes when twitching occurs.
• Wear sunglasses outside, which can help reduce sensitivity to light.

In severe cases, surgery can be done to remove some of the muscles and nerves in the eyelids.

When to see a doctor

Eyelid twitching is rarely serious enough to require emergency medical treatment.

However, if involuntary twitching is accompanied by the following symptoms, you should consult a health care professional as soon as possible:

• The eyelid completely closes when the twitching occurs.
• The upper eyelid droops.
• The twitching or spasms continue for several weeks.
• The twitching or spasms start to affect other parts of the face.
• The eyes become red or swollen or have unusual discharge.

Sources: American Academy of Ophthalmology; National Library of Medicine; Mayo Clinic; National Eye Institute.