Eye Twitching (Blepharospasms) – Causes, Types & Treatment

Eye twitches, or blepharospasms, are involuntary spasms of the eyelid that usually occur sporadically every couple seconds, usually in bouts that can last anywhere from a few minutes to a couple of weeks. The spasms can range from slight annoyances to being strong enough to close your eyelid completely for a split second. Most blepharospasms do not hurt at all, and are relatively harmless aside from being extremely annoying at times.

What Causes Eye Twitching

Eye TwitchingEyelid muscle contractions can be triggered by practically anything that stresses your body, including emotional stress, eye strain, head injury (concussion), lack of sleep, dry eyes, too much of a stimulant or intoxicant (i.e. – coffee or alcohol), allergies, or nutritional imbalances. Some drugs can also cause blepharospasms, and the condition is known to be a symptom of benzodiazepine withdrawal.

Blepharospasms often precede or accompany dry eyes, blepharitis, pink eye (conjunctivitis), and light sensitivity. In rare cases, eye twitching may be a sign of Bell's Palsy, tourette syndrome, or drug side effects, but other symptoms would usually be present. 

Types of Eye Twitches

Although most cases of eyelid twitching are benign (harmless), there are two types of eye twitches, chronic benign essential blepharospasms and hemifacial spasms, that can be caused by underlying disorders or serious neurological conditions, and should be diagnosed and treated by a professional ophthalmologist.

Although it is possible to have benign blepharospasms for a few days before they disappear without treatment, in some cases the condition may become chronic, causing significant social and emotional challenges, until the root of the problem is found and corrected. Although this type of chronic eye twitching does not present any physiological threat, it can lead to great emotional stress and over time can become a daily annoyance. Furthermore, because the exact cause of the condition can be difficult to pinpoint, chronic benign blepharospasms can be the most difficult type of eyelid twitches to treat.

Hemifacial spasms are usually caused by compression of the seventh facial nerve due to the swelling of a nearby blood vessel in the brain, resulting in involuntary muscle movements on one side of the face. Fortunately, this is a condition that is easy to differentiate from the more common benign eye twitches.

If your eye twitches do not go away within 1 to 3 weeks, your eyelid completely shuts with each spasm, you have twitches in any other parts of your face, or you have red, swollen eyes or droopy eyelids, see a physician as soon as possible.

Treatment for Eye Twitching

People usually correct the imbalances that cause eye twitching naturally and subconsciously (i.e.- catching up on sleep, eating a full meal, cutting back on smoking), causing the condition to resign on its own. However, for persistent chronic cases, or those caused by a neurological disorder, there are  treatment options:

Drugs used to treat eyelid twitches typically include muscle relaxers, anti-inflammatories, and anti-anxiety pills. However, since the cause of each person's eye twitches vary, physicians and patients usually have to work together through trial and error to find the most suitable treatment. Some studies have shown that proper nutrition and a dietary supplement of magnesium chloride may be effective in treating some individuals.

Some doctors inject Botox into the eyelids of patients to cause temporary localized paralysis of the eyelid muscles. Injections are usually administered once every few months, with some patients experiencing immediate relief and others needing to wait about a week to see results. Unfortunately, some patients experience eyelid droop (ptosis), and when doctors attempt to inject the Botox into areas of the eye that would minimize eyelid droop, the effectiveness of the treatment is somewhat reduced.

If chronic blepharospasms are left untreated they could become worse to the point of causing functional blindness, as some patients find it difficult to hold their eyes open. As a last resort, a surgery known as protractor myectomy may be used to remove the facial muscles that are responsible for closing the eyelids. This treatment has shown to be effective at improving visual disability in 75-80 percent of cases.

Support groups can help you deal with the social and emotional challenges associated with chronic blepharospasms, and sunglasses can be worn to shield the condition from others and protect your eyes from sensitivity to light. 

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