A woman places her fingers on top of her eyelid
Eye twitches can be caused by environmental factors or infections, but it is treatable.
Photo Credit: VladimirFLoyd / iStockPhoto.com

Causes, Treatments and Complications of Eye Spasms

If you’ve ever experienced an eye twitch, you’re not alone — it’s a pretty common condition with a host of possible causes. Often the twitch is in the upper eyelid, and it goes away within a few minutes, hours, or maybe a couple of days.

But what if your twitch doesn’t go away? Eye twitching (known as blepharospasm) may not hurt, but they sure can be annoying. The pulsing muscle can interfere with your field of vision, or it may just be a constant distraction. When a twitch lasts for days or weeks, you may begin to worry.

Many eye spasms can be traced to harmless causes, but they’re sometimes associated with more serious conditions. While most cases are benign, you’ll want to watch for signs of a deeper problem needs to be investigated.

Infections That Can Cause a Twitch

In some cases, eye twitches come along with symptoms of an eye infection. There are dozens of different eyes problems, but some more are more likely to lead to eye twitches, including:

Conjunctivitis

More commonly known as pink eye, conjunctivitis is an inflammation of the thin film that covers the whites of your eyes. The major symptoms are redness, sensitivity, more tears, and discharge that crusts over the eyelashes.

Uveitis

Uveitis is the inflammation of the middle layer of the eye wall, the uvea. Like other infections, uveitis can bring on sudden pain, redness and blurred vision. It commonly occurs between the ages of 20 and 50.

Blepharitis

This is an inflammation of the eyelids, often caused by bacteria or a blockage in the oil glands of the eyelid. Red, itchy and swollen eyelids are common when blepharitis is at play.

Trichiasis

Trichiasis occurs when the eyelashes grow back toward the eye, rather than outward. It can be brought on by an infection or trauma, and in some cases it’s hereditary. Not surprisingly, this can be a very painful and uncomfortable condition, and surgery is often the only way to correct the problem.

Certain nervous system disorders can also bring about an eye twitch. In these cases, misfiring or malfunctioning nerve impulses send the muscles around the eye into spasm. Some of the more common nervous system disorders that affect the eyes include:

  • Tourette syndrome (spontaneous movements or speech that can be difficult to control)
  • Bell’s Palsy (sudden weakening of your facial muscles)
  • Multiple sclerosis (damage to nerve sheaths and fibers that relay messages from the brain)
  • Cervical spondylosis (degradation of the spinal disks in your neck)
  • Facial dystonia (uncontrollable muscle contractions that cause body parts to twist or move repeatedly)
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Dry eyes are an extremely common, and minor, issue that can cause eyelid spasms. In some cases, simply treating the dryness with artificial tears can get rid of the annoying twitch.

Environmental Causes of Eye Twitching

There are three types of eye twitch: minor eyelid twitch, benign essential blepharospasm and hemifacial spasm. The minor version is most often tied to environmental factors, like:

  • Alcohol
  • Caffeine
  • Smoking
  • Fatigue
  • Lack of sleep
  • Stress
  • Wind
  • Bright lights

Some of these environmental factors have a stronger impact on the eyes. When wind, stress or irritants bother the eyes too much, excessive blinking and irritation can result in benign essential blepharospasm — a slightly more severe condition that’s as medically harmless as minor eyelid twitch, but certainly more intrusive.

When to See a Doctor

Eye twitches come and go, and though it usually stops on its own, it can recur. When the cause is benign, there’s little that can be or should be done — it’s a matter of waiting for the twitch to pass.

On the other hand, major or long-lasting eye twitches can be early signs of a deeper problem, and if this is the case, it’s important to get the right diagnosis as soon as possible. If the twitches bring along any of these suspicious symptoms, it’s time to see your doctor:

  • Swelling
  • Redness, pus, or other signs of infection
  • Drooping eyelids
  • Facial spasms

The most serious category of eye twitch, known as hemifacial spasm, is very rare. It typically only occurs on one side of the face, and involves the muscles around the mouth, as well.

You should also see your doctor if the twitching causes your eyelid to close completely, or if it goes on for more than a few weeks. But even if your eye won’t stop twitching, try not to worry. It’s very rare that eye twitches signal a neurological disorder, and if an infection is to blame it can often be treated quickly and effectively with the right medication.

Treating Your Eye Twitch

Stubborn cases of benign essential blepharospasm can be treated with a shot of botulinum toxin (Botox). A simple injection at the precise site of the twitch can relax the muscles almost immediately, and the effects usually last for a few months. There are other medications that may prove useful, and in some cases, doctors recommend complementary therapies — like biofeedback, hypnosis or acupuncture — for better results.

If it turns out that a more serious disorder is to blame, you will meet with a neurologist (if the nerves are the culprits) or other specialist to get to the heart of the problem. You may need a surgical procedure to relieve the pressure on the affected nerve in the face. Some patients might need to have some nerves and muscle around the eyelid removed to enjoy permanent relief from the twitching.