Why You Have That Pesky Eye Twitch — and When to Seek Help

There’s nothing worse than trying to focus during the day with a pesky eye twitch that won’t stop flickering. You know what we mean — that repetitive, involuntary spasm of your eyelid muscle that occurs every few seconds for a minute or two.

The most common culprits behind the dreaded eye twitch are stress and fatigue. Other causes include:

• Eye irritation.
• Eye strain.
• Eyes that aren’t straight.
• Eyes that need glasses.
• Medication.
• Use of alcohol, tobacco or caffeine.

But is that twitch just annoying or can it be a sign of a more serious problem? Oculofacial plastic surgeon Julian D. Perry, MD, has your answer.

More annoying than harmful

Eye twitches are common and usually aren’t anything to worry about, says Dr. Perry. Most of the time, these unpredictable eye spasms will resolve on their own without any need for medical treatment.

“Many patients worry this may represent a neurologic problem. They worry that something serious is going on, but that’s rarely the case,” Dr. Perry says.

“Several things can cause one or both eyes to twitch and they can last for days to weeks, which can be very frustrating,” he says. “But these types of twitches are rarely a sign of a serious problem.”

To get your eye twitch to calm down, Dr. Perry suggests getting enough rest, cutting back on caffeine and reducing stress as much as possible. Eye drops also can help if your eyes need moisture.

When it’s time to see a doctor

If your eye twitching lingers for longer periods or becomes particularly bothersome, Dr. Perry recommends a visit to an eye doctor to make sure nothing more serious is going on.

Seek an evaluation if you notice any of these four signs:

1. Symptoms such as weakness, drooping or double vision.
2. Your eyes start to look red.
3. It feels like there’s something in your eye or you’re getting light-sensitive.
4. Your vision is changing.

Eyelid twitching can sometimes be a part of spasm conditions affecting the eyes, such as essential blepharospasm or hemifacial spasm. “These disorders were some of the very first indications for Botox® injections, the same medicine that we now use to treat wrinkles,” says Dr. Perry.

Very rarely, eyelid spasms are a symptom of a more serious brain or nerve disorder. In these rare cases, eyelid spasms may be an early warning sign of a chronic movement disorder, especially if the spasms are accompanied by other facial twitches or uncontrollable movements.

“While serious disorders are rare, patients who are finding those benign twitches very annoying can find quick improvement with a few injections,” Dr. Perry says. “So it’s worthwhile to come in for an evaluation if the symptoms are bothersome.”