Eye Twitching

Why is my eye twitching?

Eye twitching is an uncontrollable type of movement of your eye, the muscles in your eyelid or parts of your face immediately around your eye. In many cases, eye twitching is normal, and it’s something everyone experiences. But sometimes it can be a symptom of an issue that needs medical care.

Defining eye twitching

Eye twitching can describe several different things. Some of them have to do with your eyes themselves, while others are more likely related to nerves and muscles in your face. A key way to organize eye twitching is by defining what exactly is doing the twitching:

What are the most common causes of eye twitching?

Eye twitching can have many different causes, depending on the specific type. Some factors are common across all forms of eye twitching or can contribute to other causes. And some factors may not cause it, but they can make it worse.

The factors include:

• Stress or anxiety.
• Sleep deprivation or fatigue.
• Stimulants like caffeine.
• Prescription medications and nonmedical drug use.
• Bright lights or light sensitivity.
• Nutrition (some twitching may happen because you need certain nutrients).
• Eye strain.
• Nicotine use.

Fasciculations

Fasciculations are usually benign (harmless). They can happen for several reasons, including:

• Benign fasciculation syndrome.
• Stimulants like caffeine or nervous system depressants like alcohol.
• Physical activity or overexertion.
• An overactive thyroid gland (hyperthyroidism).
• Viral infections (the virus can affect your nerves and leave behind lingering — but usually harmless — spasms and twitches).

But in rare cases, fasciculations can be a sign of more severe neurological conditions. These can be conditions that affect your nerves, brain or both. The most well-known of these conditions is amyotrophic lateral sclerosis (ALS), better known as Lou Gehrig’s disease (for the famed U.S. Major League Baseball player who died in 1941 at age 37 because of it). 

Myokymia

Myokymia is very common. It’s often the result of multiple factors adding up, especially the common ones like stress, lack of sleep, caffeine, etc.

In some cases, though, myokymia has very specific causes. They include:

• Medications (including antipsychotics, antiseizure drugs or calcium channel blockers).
• Autoimmune and nervous system conditions like multiple sclerosis (MS), or tumors like gliomas (it’s rare for either to be the cause of myokymia, though).

Blepharospasm (eyelid spasms)

Blepharospasm has two types: primary and secondary. Primary means it happens without another condition or issue causing it. Secondary means it happens as an effect of something else.

Benign essential blepharospasm (BEB) is the most common primary form of this condition. Experts know BEB happens for nerve-related reasons, but they don’t yet fully understand how or why. It also tends to cause a few other symptoms, especially light sensitivity (photophobia) and dry eye.

Secondary causes of blepharospasm can include:

• Dystonia or conditions that can cause it.
• Meige syndrome (but there’s some debate about whether this condition causes eye twitching or only happens alongside it).
• Tardive dyskinesia.
• Certain medications, especially Parkinson’s disease medications.
• Wilson’s disease (a rare genetic condition that makes copper accumulate in your body).
• Seizures and epilepsy (rare).

Hemifacial spasm

This type of twitching can involve your brain, nerves on one side of your face or both. It’s unpredictable and uncontrollable.

This also has primary and secondary forms. The primary form usually happens when blood vessels in your face curl, form a loop and press on a nerve. The compressed nerve reacts and fires signals to attached muscles, causing twitches and spasms.

Hemifacial spasm can also happen as a secondary effect of more serious conditions. They include:

• Trauma and injuries that cause nerve or brain damage.
• Bell’s palsy.
• Dystonia (this can also happen with other forms of eye twitching).
• Lesions on your brainstem.
• Brain tumors (including cancer).
• Tumors on your parotid glands (these produce saliva, and they’re near the upper back of your mouth on the inside of your cheeks).
• Middle ear infections (otitis media) or infections of surrounding structures, like mastoiditis.

Nystagmus

Nystagmus is an uncontrolled back-and-forth (oscillation) movement of your eyes. Some forms of it are normal and expected. They can happen because of how your eyes move or follow movement.

Other forms of nystagmus are more situational. For example, nystagmus is more likely to happen if you’re tired, consume caffeine or alcohol (especially when your blood alcohol content is high enough to cause intoxication), and more.

And nystagmus can also be a sign of certain diseases. Your eye care specialist may refer you to another specialist, like a neurologist, if they suspect this could be the case.

How is eye twitching treated?

The treatment for eye twitching depends mainly on why it’s happening. And sometimes, it doesn’t need treatment at all because it’s happening for reasons that are normal and harmless.

Healthcare providers can easily treat some causes of eye twitching with medications like onabotulinumtoxinA injections (often known as BOTOX®) or others. Some causes might need other treatment approaches, like corrective eyeglasses or contacts or specific types of surgery.

Because there are so many different causes and treatments, your healthcare provider or eye care specialist is the best person to explain what the treatment options are. They can guide you and help you pick one that has the best chances of success for your unique situation and needs.

What can I do at home to treat eye twitching?

Most of the time, eye twitching happens because of minor day-to-day issues or changes. Some things you can do that might help include:

• Make sure you get enough sleep.
• Eat a balanced diet to make sure you get enough nutrients (including ones that can help with eye or muscle twitching).
• Try to limit or reduce your stress.
• Limit how much caffeine you consume.
• Quit using nicotine products or avoid them entirely. If you use them, your healthcare provider can give you resources to help you quit.

Can eye twitching be prevented?

Eye twitching can happen unpredictably or for reasons experts don’t yet understand. That means you can’t prevent eye twitching with 100% certainty. But the steps mentioned above that may help it go away — from causes like lack of sleep, fatigue, too much caffeine or high stress levels — can also reduce the risk of having it.

When should eye twitching be treated by a doctor or healthcare provider?

You should talk to a healthcare provider or an eye care specialist about eye twitching if:

• The twitching doesn’t go away after a few days of trying the home treatment approaches mentioned above.
• The twitching affects your vision.
• The twitching otherwise starts to interfere with your life.

Eye twitching is usually nothing to worry about, but a qualified medical expert is the best person to make that call. When in doubt, the best choice is to err on the side of caution and talk to a medical professional.

Can my eye twitching lead to other problems?

Many eye issues can happen with or because of eye twitching, and eye twitching can make some conditions worse. Conditions that can happen with, cause or make eye twitching worse include:

• Blepharitis (swollen eyelids).
• Conjunctivitis (pink eye).
• Corneal scratches.
• Dry eyes.
• Red eyes.
• Uveitis (swelling of the uvea, the eye’s middle layer).