Do your eyelids twitch once in a while? This twitching, called fasciculation, is pretty common-and it can affect the upper eyelids, involve muscles in the lower eyelids, or both. The twitch may happen in one or both eyes and can occur spontaneously and uncontrollably. And once it starts, eye twitching can continue off and on for several days or longer and then disappear.Eye doctors are not sure what causes eyelids to twitch, but they believe it may often be related to stress and fatigue. In some cases, the cause of a twitching eye condition may never be identified."The most common causes of twitching eye include stress, lack of sleep, and excess caffeine," says Alberto Martinez, MD, an ophthalmologist in Bethesda, Md, and a spokesperson for the American Academy of Ophthalmology.
Other causes can include eye irritation, eye strain or dry eyes.In rare cases, a twitching eye may be an early sign of a neurological disorder such as blepharospasm (an abnormal blinking or spasm of the eyelids) or amyotrophic lateral sclerosis (ALS), more commonly known as Lou Gehrig's disease. Twitching eye conditions that are more serious, such as those in which the eyelid completely closes and has severe contractions, are often caused by irritation of the cornea (the surface covering the iris and pupil) or the conjunctiva (the membrane that lines the eyelids and white of the eye).
What your eye doctor will look for
If your eyelid twitch does not go away in a week, or if symptoms become worse or you are bothered by the twitch, you should be evaluated by an eye doctor. Your doctor will perform a comprehensive eye exam to rule out eye diseases and conditions such as dry eye. He will also look for other symptoms that may be accompanying the twitching eye, such as sensitivity to light. Eyelid twitches that travel down the face or involve other facial muscles are definitely cause for further evaluation.Your doctor will check for other symptoms such as grimacing or facial spasms, and will probably refer you to your primary care physician for follow-up.
Treating twitching eyes
In most cases, a minor eyelid twitch does not require treatment and will go away on its own. In some instances, just going to the eye doctor for an evaluation can help alleviate symptoms."Doing a full eye exam can almost have a placebo-like effect," says Dr Martinez.Doing what you can to reduce stress, getting more sleep, and cutting down on your caffeine intake can help relieve twitching eye. "You can also try warm compresses to relax the muscles around the eyes," suggests Martinez.If the eyelid twitch is severe, your doctor may refer you to a neuro-ophthalmologist, who may offer you provides botulinum toxin injections, otherwise known as Botox, to temporarily stop the spasms. Surgical options, such as a myectomy-a procedure that involves removing or cutting some of the muscles and nerves of the eyelids-may relieve some symptoms of severe blepharospasm.So don't get stressed about a little twitch. But if symptoms persist and are bothersome, see your doctor to rule out more serious eye and neurological problems.