Eye Twitching

January 16, 2018

An eye twitch is an involuntary, abnormal blinking of your eyelid. This abnormal blinking may happen many times per day. If eye twitching is severe, it can impair vision.

The orbicularis oculi is a muscle of the face that closes your eyelid. The levator palpebrae superioris is a muscle that elevates your eyelid. Problems with either of these muscles (and sometimes both) may cause your eye to twitch. Other eye muscles also may contribute to eye twitching.

Many people experience an occasional eye twitch, especially when they are tired or have had a lot of caffeine. Frequent eye twitching is fairly uncommon. Anyone can have eye twitching, but it is particularly common in middle-aged and elderly women.

Usually, eye twitching that happens often is due to a condition called benign essential blepharospasm. This is a type of focal dystonia. Researchers aren’t sure exactly what causes it, but it can cause problems with these muscle groups around your eye. Researchers think problems with the basal ganglia (a part of the brain) might play a role. Having certain genes may contribute to eye twitching in some people as well.

Rarely, another problem with the brain or nervous system might cause eye twitching. These problems include:

  • Parkinson disease
  • Brain damage from inflammation or a stroke (especially to the thalamus, basal ganglia, or brain stem)
  • Reaction to certain psychiatric medicines
  • Meige syndrome
  • Multiple sclerosis
  • Bell palsy

These medical conditions usually have additional symptoms as well.

A history of head trauma may increase your risk of eye twitching. You may also be at greater risk if it runs in your family, or if you have used certain psychiatric medicines.

Eyelid twitches vary quite a bit in severity and frequency. Some people might have eyelid twitches every few seconds, but others might have them much less often. Your eye twitches may last for a few days or longer and then go away for a while. In some people, eye twitching happens more often and lasts longer over time. In many others, symptoms go away and don’t come back.

Usually, only the upper lid twitches. Probably both of your eyes will twitch, but sometimes only one eye shows symptoms. Your eyelid might just shut partly, or it might shut all the way closed.

In addition to eyelid spasms, you might note the following symptoms:

  • Eye irritation (often a first symptom)
  • Increased rate of blinking
  • Light sensitivity
  • Dry eyes
  • Interference with vision (if twitching is frequent)
  • Facial spasms

Symptoms of eye twitching often go away when a person is sleeping or concentrating on a difficult task. Many people find that certain tasks may make their eye twitching go away temporarily, like talking, singing, or touching another part of the body.

Other situations may increase the likelihood of symptoms. These include:

  • Fatigue
  • Stress
  • Bright lights
  • Driving
  • Caffeine
  • Eye irritation from another cause

Diagnosis begins with a medical history and physical exam. This often includes a full neurological and eye exam. Often, a healthcare provider who specializes in the eyes (ophthalmologist) will make the diagnosis. If your healthcare provider rules out other causes of eye twitch, he or she may diagnose you with benign essential blepharospasm. Usually, you won’t need any other tests. In some cases, your healthcare provider might get imaging of your brain with a CT (computed tomography) scan or an MRI (magnetic resonance imaging). This can rule out other medical causes of eye twitch.

You might not need any treatment if you don’t have significant symptoms from eye twitching. Getting more rest and reducing your caffeine intake might help relieve your symptoms.

If your eye twitching is more significant, your healthcare provider might recommend a botulinum toxin injection into the muscles of your eyelids. This may paralyze the muscle that is abnormally contracting.

Your healthcare provider might have you try a medicine to treat eye twitching. These medicines tend to only reduce symptoms in the short term, and they don’t help everyone.

If your eye twitching is still severe, you may need a surgery called a myectomy. In this surgery, healthcare providers remove some of the muscles and nerves of your eyelids. This stops symptoms in many people.

Your healthcare provider will also need to treat any underlying medical conditions that might be causing your eye twitching (like Parkinson disease).

If eye twitching is chronic and severe, it can permanently damage your eyelids and the other structures in the area. This can cause complications like the following:

  • Upper eyelids resting lower than normal
  • Eyebrows resting lower than normal
  • Excess skin in the upper or lower eye
  • Abnormal folding in of the eyelids

Some people with chronic eye twitching also eventually develop muscle spasms in other parts of the body, like the jaw or neck.

If your eyes sometimes twitch, you can take steps to reduce your symptoms:

  • Avoid caffeine
  • Get enough sleep
  • Reduce stress
  • Reduce other sources of eye irritation (for example, by using eye drops)
  • Use sunglasses when needed

Call your healthcare provider if your eye twitching lasts longer than a week. Also call if you have new or additional symptoms, like other facial spasms or discharge from your eye.

An eye twitch is an involuntary, abnormal blinking of your eyelid. If your eye twitching is frequent, it may impair your vision.

  • Occasional eye twitches are common. If you have eye twitches more often, you may have a condition called benign essential blepharospasm.
  • In rare instances, eye twitching signals an underlying medical condition.
  • Bright lights, stress, fatigue, caffeine, and eye irritation may make symptoms of eye twitching worse.
  • You might not need any treatment for your eye twitching. Or you might need botulinum toxin treatments on your eye muscles. You also might eventually need surgery.
  • Call your healthcare provider if your eye twitching lasts longer than a week or if you have new or additional symptoms

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.


January 16, 2018


Classification and evaluation of dystonia: Blepharospasm. Up To Date, Clinical features of multiple sclerosis in adults. UpToDate, The detailed neurologic examination in adults: Eye Movements. UpTodate

Reviewed By:  

Shelat, Amit, MD,Fraser, Marianne, MSN, RN