Eye twitching

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at December 10, 2015
StartSymptomsEye twitching

The majority of people experience eye twitching sometime during their lifetime. Twitching can occur to anyone at anytime regardless of age or gender. In most instances, the episode lasts from a few seconds to a few minutes before resolving untreated. Others may have recurring events. The condition happens for any number of reasons but is typically harmless.


Definition & Facts

The medical term blepharospasm refers to the common condition known as eye twitching. The twitch can occur in one or both upper or lower eyelids and is characterized by the repetitive and involuntary spasms of the muscles in the affected eyelid. The occurrence is generally painless and feels like a gentle tugging motion. However, some experience significant spasms that cause the eyelids to close completely.

Blepharospasm is categorized as being essential or reflex. The involuntary movements are usually of unknown origin though some situations may contribute to or exacerbate the problem. Twitching symptoms may last seconds, minutes, hours or days before ceasing. Reflex blepharospasm means that the twitch occurs in response to a condition causing localized inflammation, irritation or pain in or around the eye.


Intermittent spasms usually do not have a known cause. The brief amount of time that the spasm occurs does not send most people seeking medical assistance. However, healthcare providers believe that certain factors can contribute to the condition or make the situation worse. In mild cases, the twitching might be caused by:

In more serious cases, individuals experience what is known as benign essential blepharospasm. In this case, the spasms become chronic and often affect both eyes. It is estimated that approximately 50,000 adults middle aged and older experience this form of eye twitching. For many the condition grows progressively worse and may lead to blurred vision, light sensitivity or facial spasms.

Chronic conditions may be caused by or made worse from:

When to see a doctor

In general, eye twitching is not considered serious or an emergency that requires medical intervention. However, when the condition becomes chronic, the spasms might be a symptom of a more serious underlying medical ailment affecting the brain or the central nervous system. Individuals should seek the advice of a physician if experiencing blepharospasm chronically and especially if accompanied by:

Brain or nerve disorders that might contribute to the problem include:

  • Bell's palsy, which refers to an inflammatory process in the facial nerves caused by some type of microbial infection
  • Cervical dystonia, which causes spasms in the head and neck
  • Cervical spondylosis refers to an age-related condition in which the discs and vertebrae deteriorate, may form bony prominences and cause nerve pressure along with a variety of symptoms.
  • Dystonia that causes involuntary spasms anywhere in the body
  • Multiple sclerosis, which affects the central nervous system and is caused by lesions on nerve tissue or deterioration in the protective nerve covering and affects neurological communication
  • Parkinson's disease caused by nerve tissue deterioration that leads to progressive uncontrollable muscle spasms and tremors
  • Tourette syndrome caused by abnormalities in the brain that manifest as involuntary facial or body movements and uncontrolled speech patterns.

Treatment & Therapy

While typically harmless, eye twitching that recurs or becomes chronic can be annoying or make sufferers self-conscious. There are a few lifestyle changes and self-help techniques that may help resolve the condition. These methods include:

  • Applying a warm, moist compress over the eye at the first sign of spasms
  • Evaluating stress levels and finding ways to unwind and relax
  • Getting a sufficient amount of sleep
  • Modifying alcohol or caffeine consumption
  • Stop using tobacco products
  • Using OTC lubricating eye drops

One of the most widely recommended medical treatments, involves Botox injections. Created using the botulinum toxin, the serum serves to relax muscles affected by spasms or tremors. However, the treatment only provides temporary results that last up to six months. For some, the medications clonazepam, lorazepam or trihexyphenidyl are helpful. A physical therapist might be helpful by providing the patient with exercises that retrain facial and eye muscles. Depending on the cause, healthcare providers might also suggest trying:

In rare instances when conventional treatments offer no relief, surgeons may remove the delicate muscles and nerves prone to twitching. Though considered radical by some, the intervention offers an effective resolution of symptoms for up to 85 percent of affected patients. Individuals suffering from hemifacial spasms also may undergo surgery to alleviate the pressure endured by the affected nerves cause by large blood vessels. Surgical intervention offers a permanent solution but is not without the possibility of complications or risks. Any side effects caused by procedures are typically permanent.

Prevention & Prophylaxis

If eye twitching happens on a continual basis, consider starting a journal. Keep track of alcohol and caffeine consumption levels and the amount of tobacco use. Include situations that may be causing ongoing stress or circumstances causing more stress than usual. Write down the amount of sleep obtained every night.

Document when the twitching starts, the duration and intensity of each occurrence. Perhaps in this way a correlation will emerge between the events and certain habits. Make lifestyle corrections as needed. If alterations do not provide the desired results, the notes taken could go a long way in helping a healthcare provider make an accurate diagnosis.

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