A twitching eye is often annoying. But is it a reason to worry that your nerves may have gone haywire? One expert, Neil Miller, professor of neuro-ophthalmology and neurosurgery at Johns Hopkins School of Medicine, offers his views on how to cope when a sudden twinge comes on.
What causes your eyes to twitch?
Eye twitching is incredibly common-almost everyone experiences an episode of it at some point in their lives, says Dr. Miller. “Most of the time it’s nothing,” he says. “It goes away in a couple of weeks.”
The most common type by far is known as eyelid myokymia. Usually this involves undulating movements across the lower lid of one eye. The cause is almost always greater than normal stress, lack of sleep or excessive caffeine intake, says Dr. Miller.
If both eyes are twitching, blepharospasm might be suspected, though this is more rare. It occurs more among older people, although its exact cause isn’t known. Doctors used to think this type of bilateral twitching was stress related, and while it does tend to worsen with stress, Dr. Miller says it isn’t caused by it.
What if the twitching episodes go on for days?
Most of the time with eyelid myokymia, the episodes go away within a few weeks.
Even if they persist, Dr. Miller says it is nothing to worry about. It was once believed that if the spasms lasted several months or longer, they might point to a brain tumor or multiple sclerosis, he says. But studies have shown that isn’t the case, he says. “Even if it’s chronic, it’s OK,” he says.
Is there anything you can do to get rid of eye twitching?
For myokymia, reduce stress, especially if it is above what you’re normally used to. Also, cut back on caffeine and see if that helps. If a person who typically gets seven hours of sleep a night is suddenly making do on five, it makes sense to try to restore the old pattern and see if the twitching improves, he says.
Reading, screen time and driving shouldn’t pose problems, though the twitching can be annoying when trying to concentrate.
Wearing contact lenses should be safe, but if they seem to be causing further irritation, switch to glasses during a twitching episode.
Home remedies such as hot and cold compresses don’t do much, says Dr. Miller. Closing your eyes to rest them typically won’t make the twitching go away, but taking a nap might.
The less-common blepharospasm tends to need a medical solution. Injections of botulinum toxin A-the same substance found in Botox-can help, says Dr. Miller. There are also surgical approaches and prescription drugs that might help relax the facial muscles.
The twitching associated with blepharospasm can be lifelong.
When should you worry?
In rare cases, if the entire side of the face starts twitching, the spasm might be caused by an underlying growth or aneurysm pressing on a facial nerve.
Sometimes blood vessels can also compress a nerve. In these situations, surgery might be recommended, says Dr. Miller.