No one knows what causes this, which your doctor might call blepharospasm. When it happens, your eyelid, usually the upper one, blinks and you can’t make it stop. Sometimes it affects both eyes. The lid moves every few seconds for a minute or two.
Doctors think it can be linked to:
Twitches are painless, harmless, and usually go away on their own. But if the spasms are strong enough they can cause your eyelids to completely shut and then reopen.
What if It Doesn’t Stop?
Some people have eye spasms all day long. They might go on for days, weeks, or even months. That can upset you and affect your quality of life.
It’s rare, but if your twitch doesn’t go away, it might make you wink or squint all the time. If you can’t keep your eyes open, it’s going to be hard for you to see.
Sometimes, the twitch can be a sign of a more serious conditions, like:
Very rarely, it’s a sign of a brain or nerve disorder, such as:
What Are the Types of Twitches?
There are three common ones.
A minor eyelid twitch is often associated with lifestyle factors, like:
It can also result from irritation of the surface of your eye (cornea) or the membranes that line your eyelids (conjunctiva).
Benign essential blepharospasm usually shows up in mid- to late-adulthood and gradually gets worse. Only about 2,000 people are year are diagnosed with it in the United States. Women are twice as likely to get it as men. It isn’t a serious condition, but more severe cases can interfere with your daily life.
It starts with nonstop blinking or eye irritation. As it gets worse, you may be more sensitive to light, get blurry vision, and have facial spasms. In serious cases, the spasms can become so intense that your eyelids stay shut for up to several hours.
Researchers believe it results from a mix of environmental and genetic factors. Although the condition is usually random, it sometimes runs in families.
A hemifacial spasm is rare. It involves both the muscles around your mouth and your eyelid. Unlike the other two types, it usually affects only one side of the face.
Most often, the cause is an artery pressing on a facial nerve.
When Should I See a Doctor?
Make an appointment if:
- The twitch lasts for more than 1 week
- Your eyelid closes completely
- Spasms involve other facial muscles
- You see redness, swelling, or discharge from an eye
- Your upper eyelid droops
If your doctor suspects a brain or nerve problem is to blame, she’ll check for other common signs. She might refer you to a neurologist or other specialist.
How Is It Treated?
If dry eyes or irritated eyes are the cause, try over-the-counter artificial tears. That can often ease a minor twitch.
So far, doctors haven’t found a cure for benign essential blepharospasm. But several treatment options can make it less severe.
The most widely used treatment is botulinum toxin (Botox, Dysport, Xeomin). It's also often used with a hemifacial spasm.
A doctor will inject small amounts into your eye muscles to ease the spasms. The effect lasts a few months before it slowly wears off. You’ll need repeat treatments.
In mild cases, your doctor might suggest medications like:
These usually provide only short-term relief.
Alternative treatments include:
Scientific studies haven’t proven these treatments work.
If other options fail, your doctor may suggest surgery. In a procedure called a myectomy, your surgeon will remove some of the muscles and nerves around your eyelid.
Surgery can also relieve the pressure of the artery on your facial nerve that causes a hemifacial spasm. The results are permanent, but as with any operation there’s a chance for complications.