Why does my eyelid keep twitching?

Settling in to work with your usual coffee, tea or energy drink in hand, you frown as you feel a constant, minor sensation of a muscle in your eyelid twitching, over and over again. It doesn’t mean you can’t see, but it’s deeply irritating and seems to come and go without cause.

Ophthalmologist Kathleen Albrecht, MD, explained what causes eyelid twitching to start and what you can do to get it to stop.

Common causes of eyelid twitching

“Basically, your orbicularis muscle goes around your eye and is what controls blinking or closing the eye,” said Dr. Albrecht. “Myokymia is the medical name for when this muscle starts to contract without your control, causing that twitching sensation. It’s actually something that eye doctors get asked about pretty often. It’s a very common problem, and there’s actually a lot of different underlying issues that can cause it to happen.”

The most common cause of eyelid twitching something irritating the surface of the eye or the undersurface of the eyelids.

Why dry eyes might be the culprit

“Too long staring at a computer screen, your cell phone or really anything that affects your normal blinking time can lead to eye strain,” said Dr. Albrecht.

The normal blinking time is about twenty times per minute. When reading, focusing on screens or doing anything that affects how often you blink, you might only be blinking ten or even four times per minute, causing your eyes to feel dry, tired and strained.

Sometimes, that can lead to irritating, uncomfortable eyelid twitching.

Eye strain can be remedied using dry eye drops and taking breaks to ensure your eyes get plenty of ‘rest’, even when you aren’t sleeping.

Windy days, air pollution, bright lights and other irritants can cause issues, too

“Bright lights, windy days and air pollution can all create irritation to the sensitive eye area, leading to the same problem,” said Dr. Albrecht. “Sunglasses on bright and sunny days can help to cut down on the glare of bright light hitting your eyes, but we also see this issue for those who drive at night and deal with bright headlights, or who need to drive in snow during winter when the sun reflects off the snow and surface.”

Try to stay inside on days when air pollution is at its worst. Your local news will often list air quality alerts, so check for those. Even something as simple as heavy pollen can affect air quality, especially for those with existing allergies.

Stressed out and tired? Rethink reaching for that third cup of coffee

“Excess caffeine can be a trigger for eyelid twitching,” said Dr. Albrecht. “So can overuse of alcohol and nicotine, whether from cigarettes, chewing tobacco, vaping or other methods. Stress and fatigue are often ‘treated’ through these methods, which don’t treat the underlying problem at all but provide a ‘quick fix’ that can cause larger problems down the line. Eyelid twitching is just one of them.”

Smoking creates a whole host of health problems, but quitting can help, even if you’ve been smoking for years. Cut down on your intake of caffeine by choosing to order your morning latte half-caf or by drinking decaf. A switch to black tea may also help, as tea has less caffeine per cup than coffee does, but it’s still possible to overdo it.

Try to treat the root cause of your stress and fatigue, rather than treating the symptoms. More restful sleep or making adjustments to your lifestyle can help!

Inflammation, medication and other less common causes of eyelid twitching

“Blepharitis, which is an inflammation or infection of the eyelids or lashes, can also cause eyelid twitching, because it irritates the surface of the eye,” said Dr. Albrecht.

Eyelid twitching can also be a side effect of some medications, like those used to treat Parkinson’s disease. If you take regular medication, check the listing of potential side effects you should have received or speak with your doctor.

Rarely, eyelid twitching can be linked to certain nervous system problems, although it would be accompanied by other signs and symptoms.

Nervous system problems that could cause eyelid twitching include:

• Bells palsy, a condition where one side of the face has sudden paralysis or weakness
• Dystonia
• Multiple sclerosis
• Oromandibular dystonia and facial dystonia
• Parkingson’s disease
• Tourette syndrome

“There are also two movement disorders associated with eyelid twitching, where the spasms are more sustained and persistent,” said Dr. Albrecht. “Benign essential blepharospasm is a type of dystonia and would cause eyelid twitching on both sides. Generally, one significant sign of this cause is that the twitching goes away when sleeping. We treat this using Botox, usually on a three-month basis.”

Finally, hemifacial spasm is another dystonia, which affects only one side of the face. It goes beyond eyelid twitching and often causes involuntarily muscle spasms in the lower part of the face as well. It’s connected to compression of the facial nerve by a blood vessel in the brain in some cases, but usually there isn’t a direct cause found.

In the case where the facial nerve is involved, it can be treated with surgery. Otherwise, Botox every three months can help control the problem.

See your eye doctor about treatment for eyelid twitching

“An optometrist or ophthalmologist can treat myokymia and help you get back to feeling more yourself,” said Dr. Albrecht. “Whether it’s as simple as cutting down on caffeine or needs a more significant surgical treatment, you can find relief! Just let your eye doctor know you’re struggling with these spasms and need some help.”