What to Know About Eyelid Twitching

Medically Reviewed by Dany Paul Baby, MD on August 24, 2022
4 min read

Moderate twitching of your eyelids (also known as myokymia) is common and can be caused by several conditions. We will describe some of the conditions that could lead to myokymia, its symptoms, and how you can stop it.

A muscle known as the orbicularis oculi is responsible for closing your eyelids. Myokymia occurs when this muscle contracts involuntarily, causing uncontrollable twitching movements.

This condition occurs due to the activity of the striated muscles, a group of tissues that convert chemical energy to physical actions.

The striated muscle causes an instinctive, mild, and continuous contraction. Myokymia typically affects only one eyelid but is known to occur more often in the lower eyelid. These contractions start and stop voluntarily and can last for a few seconds or hours. There have been reports of some chronic contractions that last for days or even weeks. Myokymia is more common in females, and in rare cases, contractions occur in the upper and lower eyelids.

In most cases, the eyes twitch mildly, but sometimes it can become very irritating. While eyelid myokymia is a condition that causes continuous, involuntary, and soft twitching of the eyelids, it’s sometimes confused with other states. It’s important to understand the differences between these conditions.

Hemifacial spasm. This leads to muscle contractions on one side of your face and affects your eyelids. Medical experts believe this condition is caused when a blood vessel touches a nerve in your face.

Essential blepharospasm. In this condition, your eyelids twitch for a longer time, and the involuntary movements could lead to limited or complete closure of the eyelids. People with this condition usually have a severe functional impairment that needs long-term treatment.

Meige syndrome. This is also known as Brueghel syndrome and is commonly found in people with essential blepharospasm. People with Meige syndrome encounter jaw and tongue spasms that extend up to the eyelids. Although the exact cause of Meigh syndrome is unknown, medical experts believe it’s linked to your brain's basal ganglia. Meige syndrome could lead to severe and painful spasms.

Your eyelids can spasm without any underlying cause. Doctors typically don’t try to dig deep as it’s not a major health concern. But some conditions may lead to or even aggravate eyelid twitches. These include:

  • Side effects of some drugs
  • Fatigue
  • Inadequate sleep
  • Too much physical effort
  • Intake of caffeine, tobacco, or alcohol
  • Stress
  • Exerting your eyelids
  • Irritation in the eyes

Sometimes eyelid twitching can also be caused by:

  • Sensitivity to light
  • Injury to your cornea
  • Dry eyes
  • Uveitis (eye inflammation)
  • Blepharitis (inflammation of the eyelids)

The most common symptom of myokymia is the twitching of the lower eyelid. Sometimes, you may feel your eyes twitching intensely, although that may not be true. People around you typically cannot notice your eyes twitching. In extreme cases, twitching can cause your eyes to close for a long time, ranging from a few minutes to several hours. Symptoms may become more obvious over time.

Eye twitching symptoms may not occur when you’re asleep or focused on a specific task. Several individuals reported their twitching ceased for some time when they concentrated on tasks like singing or speaking.

In very rare cases, the twitching of your eyelids could indicate a severe nerve or brain condition. Eyelid twitches caused by such extreme conditions are typically accompanied by other symptoms. Some underlying conditions that could lead to eyelid twitches include:

Multiple sclerosis. This condition affects your central nervous system and causes movement and cognition complications.

Parkinson’s disease. This disease leads to muscle stiffness, tremors in your hands and legs, balance issues, and speech difficulty.

Tourette’s syndrome. This condition is identified by vocal tics (making unintentional sounds) and uncontrolled movements.

Cervical dystonia. This condition makes you twist your head into awkward positions and causes sudden neck spasms.

Bell’s palsy. This disease, also known as facial palsy, causes one side of your face to slump.

In some cases, inflammation or a stroke could cause damage to the brain stem, thalamus, and basal ganglia. This could also lead to eye twitches.

In most cases, eye twitches fade away without treatment, although this may take a few days or weeks. You can take some of the following precautions to reduce the twitching:

  • Avoid possible causes of eye irritation
  • Limit or completely stop your caffeine, tobacco, and alcohol intake
  • Get adequate sleep
  • Lower your stress levels using effective practices such as meditation, breathing exercises, and physical exercise
  • Wear sunglasses

If the twitching lasts for a very long time or makes it difficult to do simple activities like opening and closing your eyes, check with your doctor to understand what can be done. This happens very rarely, and your doctor may prescribe some medicines. In some cases, your doctor may also recommend injecting botulinum toxin into the skin near your eyes to prevent the twitching. Botulinum toxin injections could have side effects such as minor lesions where the needle comes into contact with your skin, drooping of the eyelids, or double vision. In extreme cases, your doctor may suggest surgery.

Other myokymia treatments such as drinking tonic water and increasing your intake of calcium, folic acid, phosphorus, and multi-vitamins are also commonly recommended. But there’s no scientific evidence regarding the effectiveness of these methods.

Mild, temporary eye twitching is common and is usually not a sign of a serious health condition and often does not need treatment. You’ll find your twitching has reduced if you lower your stress, get enough sleep, and reduce your intake of caffeine and alcohol.

While myokymia is not serious, it may sometimes indicate the presence of underlying conditions such as Parkinson’s disease, multiple sclerosis, Bell’s palsy, Tourette’s syndrome, and cervical dystonia. In some cases, conditions like essential blepharospasm, Meige syndrome, or hemifacial spasm cause your eyelids to twitch. If your symptoms last unusually long, bring it to your doctor’s notice to understand the best way forward.