Myokymia, or eyelid twitches, are fairly common – most of us have had an eyelid twitch uncontrollably at least once in our lives. Usually, it’s the lower lids that twitch, but the upper lids can twitch, as well. Fortunately, most eyelid twitches come and go fairly rapidly. However, sometimes eyelid twitches can last for days, weeks, or even longer.
As an eye doctor, I am often asked about the various causes of eyelid twitching. Most eyelid twitching is benign, meaning it is not a sign of a serious medical problem, but it can be very annoying. Sometimes eyelid twitches can be eliminated by making simple lifestyle changes to eliminate the causative factor(s). There are many different triggers for eyelid twitches, some of which can include:
- Eye Strain
- High-Octane Beverages (caffeine and alcohol)
- Dry Eyes
- Nutrient deficiencies in our diet
While most of us live with stress as a normal part of our daily lives, not everyone’s bodies respond the same way. While it is not truly realistic for someone to suggest that we eliminate stress in our lives, we can take steps to reduce it; getting more sleep, learning to meditate, spending time with friends or pets, or even beginning an exercise or yoga routine can help reduce stress.
Lack of sleep can cause stress for our bodies, and as mentioned above, making a point to get more sleep is often an easy way to eliminate or reduce stress, which may help reduce eyelid twitches.
Eye strain, like fatigue, can contribute to overall stress for your body. Make sure that your glasses or contact lens prescription is up-to-date, and talk to your eye doctor about your daily visual tasks to make sure your eyes are not working too hard, or harder than they need to. For many people who spend all day on a computer, or focused on other near tasks (such as crocheting or knitting), many times your eye doctor will recommend a prescription for a specific pair of computer (or knitting, etc.) glasses to help relieve eye strain when engaged in these tasks.
Caffeinated and alcoholic beverages, which I have lumped together into my “high-octane” category, both have been shown to contribute to or cause eyelid twitches. Try cutting back on these substances for a week or two (remembering that caffeine can also be found in chocolate and soft-drinks) and see if the lid twitching improves.
Caffeine and alcohol can also contribute to dry eyes, another common cause of eyelid twitching.
Collecting more birthdays puts everyone at risk of developing dry eyes, which is very common in post-menopausal women, as well as men over the age of 50. We are also seeing an increased number of cases of severe dry eye in younger patients who spend many hours on a computer, tablet, etc. every day. People who wear contact lenses, or take certain medications, such as antihistamines, are also at higher risk of developing dry eyes.
In addition to eyelid twitches, other common symptoms of dry eyes include red eyes, itching, burning, watering (yes – dry eyes can water excessively, though it sounds counter-intuitive), or fluctuating vision that improves with blinking. If your eyelid twitches and you experience any of these other symptoms, please contact your eye doctor for a dry eye workup.
Some researchers say that lack of certain nutrients, such as magnesium or potassium, can trigger eyelid twitches. If you suspect that you may be suffering from a nutritional imbalance that is causing your eyelid twitching, I suggest that you consult with a dietician rather than selecting random supplements from your supermarket shelves, as an overabundance of certain vitamins or minerals can cause more severe health problems.
Recent research indicates that histamine, the substance our bodies release to combat allergic reactions, can contribute to eyelid twitching. Histamine is also the substance that causes our nose or eyes to water, throat to itch and swell, etc. Anti-histamines, the anti-allergy medication that so many of us take, are also known to contribute to dry eyes, as mentioned above. It is important to note that for ocular symptoms of allergies, sometimes a topical anti-histamine eye drop is necessary to fully address those symptoms rather than relying on the oral anti-histamine alone.
In Extreme Cases…
In cases where the above remedies do not work, and the eyelid twitch is not tolerable, severe eyelid twitching can be treated by botox injections. Botox injections come with their own set of risks, however, and should be discussed in detail with an oculoplastic surgeon, or a plastic surgeon who has specialized in the eyelid area, and has experience with the delicate anatomy of the eyelid.
It is important to note that this article is not intended to treat blepharospasm (hard blinks of both eyes simultaneously) or hemifacial spasm (a spasm of one side of the face) as these are neurological problems which need a special workup, and can be a sign of a serious and urgent neurological condition.
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