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Eye Twitches

A common nuisance explained

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It's so annoying, that quivering twitch below your eye. Find out what causes eye twitching and what you can do to cope.

If your eye suddenly starts twitching or flickering, don’t panic. Panicking may only make it worse. This involuntary muscle contraction is called eyelid myokymia, oracular myokymia, or simply benign eyelid twitch. It is a common occurrence for many at some point in their lives, often in young, healthy people.

What is it?

The twitching is annoying, but seldom serious. Although this condition generally resolves on its own, learning what triggers it can lessen its frequency and duration. Herbal or nutritional supplements can help alleviate symptoms and contribute to general eye health.

The major symptom of eyelid myokymia is a continuous, fine, and involuntary contraction of the upper or lower eyelid. Although it may feel very noticeable, the contractions are so fine that they are generally not visible to other people. While the eyelid twitches, it doesn’t completely close. It generally affects only one eye, but some people may experience bilateral flickering.

Untreated, oracular myokymia can last from several minutes to several hours. For some people, it goes away quickly; for others it reoccurs intermittently over days or months before stopping.

If the twitching is chronic, affects both eyes, and involves eyelid closure, it’s likely a condition called benign essential blepharospasm, a potentially more serious condition seen most often in women aged 50 and over.

What triggers eye twitching?

The cause of sporadic eye twitching is often unknown; however, health care practitioners point to behaviours or situations that are associated with or may prolong the spasms.

Chief among these are

  • lack of sleep
  • too much caffeine or alcohol
  • increased stress
  • Other factors include
  • smoking
  • fatigue
  • physical exertion
  • eye strain from concentrated periods of using computers, smart phones, or video games, or from reading or close handwork such as
    • sewing
    • squinting due to sunlight
    • side effects of drugs, especially those used for epilepsy and psychosis

Changing these behaviours may decrease the chances of getting eye twitches or lessen the severity or duration of an attack.

Lifestyle changes and treatment

Many lifestyle changes are fairly simple.

  • Get adequate sleep.
  • Reduce caffeine (coffee, tea, and soft drinks) and alcohol intake.
  • Engage in stress reduction techniques: visualization, meditation, biofeedback, yoga, tai chi, or other forms of gentle exercise such as going for a walk.
  • Quit or cut down on smoking.
  • Don’t exercise or engage in physical work to the point of exhaustion.
  • Take frequent eye breaks every 20 minutes. Change your focal point by looking away, closing your eyes, or staring off into the distance.
  • Reduce glare from windows or lights by repositioning computers and using dimmer lights.
  • Wear special computer glasses, use a screen filter, or control screen contrast to cut down on glare and eyestrain.
  • Wear sunglasses or a hat in bright sunlight.
  • Consult your doctor regarding medications to see if you can safely lessen the dose or change medicines.
  • Some simple at-home treatments may also decrease twitching and make your eyes feel better.
  • Use moisturizing eye drops or artificial tears to lubricate dry or irritated eyes. Don’t use eye drops that remove redness, as they can increase dryness and irritation.
  • Gently massage your eye.
  • Soak your eyes with warm water, using a clean, sterile pad.

For severe or prolonged cases of twitching, an ophthalmologist may recommend an injection of botulinum toxin (Botox) to temporarily stop the spasms. However, this treatment is expensive and can result in redness, bruising, infection, and pain at the site of the injection. Other eye-specific side effects include double vision, drooping or swollen eyelid, eye irritation, dry eyes, tearing, reduced blinking, and increased sensitivity to light.

When to seek health care

While eye twitching is not harmful, it may signal more serious eye conditions including

  • conjunctivitis (sometimes known as pink eye)
  • corneal abrasion, which can become infected and lead to a corneal ulcer
  • blepharitis, an inflammation of the eyelid

If the twitching is accompanied by redness, swelling, or discharge or results in complete closure of the eye, see an eye care professional. Also, get checked if you notice a sudden drooping of the upper eyelid, a possible sign of muscle weakness or nerve damage.

Although rare, oracular myokymia may be an early symptom of neurological conditions such as hemifacial spasm, Meige’s syndrome, or multiple sclerosis. In these cases the eye twitching is almost always accompanied by spasms in other parts of the face.

If the twitching is daily, interferes with activities, or is no longer limited to the eye, consult a health care professional.

Herbal and nutritional supplements for eye health

A key factor in maintaining healthy eyesight is getting the right blend of vitamins and nutrients. Among those essential to good vision are vitamins A, C, and E, as well as omega fatty acids.

Two other essential vitamins are lutein and zeaxanthin. Lutein, a carotenoid, is found in the macula and retina of the eye. Known as the “eye vitamin,” lutein is believed to filter light, protecting the eye from damage from sunlight and preventing or slowing down age-related macular degeneration, cataracts, and retinitis pigmentosa. In one study, people whose diet was rich in zeaxanthin were up to 50 percent less likely to develop cataracts.

For healthy eyes, the American Optometric Association recommends 10 mg per day of lutein and 2 mg per day of zeaxanthin. You can find blends of these eye-friendly vitamins in many natural health stores.

Herbal remedies including goldenseal, camomile, and eyebright have a long history of being used for eye care. However, many traditional remedies have not yet been proven effective in scientific studies. Be very careful if applying herbal teas, either in a compress or as a poultice, to your eyes. Nonsterile procedures increase the risk of causing or worsening an infection, while an allergic reaction can cause eye irritation.

Check with a health care practitioner before using supplements or herbs, as they can interact with other medications.

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