Emily Bedrick Graubart, MD: I'm sure we've all looked in the mirror and seen our upper and lower lid kind of quivering from time to time.
Ted Wonjo, MD: And you can feel a little jiggling of the muscle in the eyelid…Those are temporary, self-limited and mean nothing.
Emily Bedrick Graubart, MD: There are several different things that can cause eyelid twitches. Anything that irritates the eye like a dry-eye syndrome or blepharitis,
which means inflammation of the eyelids as well as external factors like stress, fatigue, alcohol intake, caffeine intake, all of these things can exacerbate lid twitching.
: I think if you have eyelid twitching that's lasting longer than a day, it's reasonable to call a physician and get an appointment.
For a new patient with this complaint of eyelid twitching, I would do a complete eye exam,
but especially pay attention to the ocular surface and the eyelids to see if there's any cause that I can quickly identify.
Patient: "I have dry eye too"
: Somebody has an aggravating factor like dry-eye or blepharitis, and we try to educate the patient on how to treat those symptoms and conditions so that they don't aggravate the lid twitching.
I tell people to lubricate their eyes with over-the-counter artificial tears. If they're putting them in every hour,
then I'd like them to use a preservative free artificial tear, cool compresses, warm compresses, whatever they feel is most comfortable to them is also helpful.
And then, if they do have blepharitis or the inflammation of the eyelids and we like to treat that with lid scrubs which are also available over-the-counter.
: And then of course, if they're having a lot of caffeine intake or smoking or drinking excessively, we try to kind of eliminate those aspects as well…
Dr. Wonjo to patient: Hi Miss Knowlin, how are you?
Emily Bedrick Graubart, MD: And in a very small percentage of the population, there's a condition called Benign Essential Blepharospasm. Those are lid twitches that do not go away and they get worse.
Ted Wonjo, MD: And by twitch, we're talking about a forceful involuntary contraction of the eyelids to the point where the patients are functionally blind.
They cannot open their eyes.
Emily Bedrick Graubart, MD: The cause is unknown. It's thought to be due to some disorder of the basal ganglia which is in our brain and the basal ganglia controls movement.
And so, this is almost like some sort of a movement disorder.
Ted Wonjo, MD: The majority of twitches are simply just that, an involuntary isolated twitch in just one little muscle.
Emily Bedrick Graubart, MD: And it's a benign condition and often reassuring the patient is, you know, really all that's needed.
