What Is a Twitching Eye a Sign of?

Infections and nerve disorders may cause eye twitching, but it can also be a harmless response to stress or fatigue.

A blepharospasm (eye twitch) is a harmless tic of the eyelid muscle, which may resolve on its own. Eye twitch causes the eyelid to blink every few seconds for a minute or two. Twitches are generally painless, but if there is a strong spasm, it causes the eyelid to shut completely and then reopen.

Twitches can be caused by 

• Fatigue
• Eye Stress
• Smoking
• Caffeine
• Medication side effects
• Light sensitivity
• Lack of sleep
• Foreign particles in the eye
• Corneal irritation

Eye twitching is generally painless and harmless and does not signify any serious medical conditions. However, persistent eye twitching can occasionally be a sign of more serious conditions like:

• Blepharitis (inflamed eyelids)
• Dry eyes
• Light sensitivity
• Conjunctivitis or pink eye

Very rarely, eye twitching can be a sign of a nerve or brain disorder like:

• Bell's palsy (A form of facial paralysis due to dysfunction of facial nerves)
• Dystonia (Involuntary muscle contractions)
• Parkinson's disease (A brain disorder caused by nerve cell damage)
• Tourette's syndrome (A nervous system disorder causing sudden involuntary movements and exclamations, often profane in nature)
• The twitches may also be a side effect of some drugs (Antidepressant medicines or epilepsy medicine)

There are three types of eye twitches, which are:

• Minor eyelid twitches: These are minor twitches associated with fatigue, stress, lack of sleep, caffeine or alcohol; corneal or conjunctival irritation.
• Benign essential blepharospasm: This results in non-stop blinking or eye irritation. As the condition advances, it can result in blurry vision, light sensitivity and facial spasms. Benign essential blepharospasm is caused by fatigue, stress or prolonged exposure to bright light or wind.
• Hemifacial spasm:  This rare condition affects the muscles around the mouth and the eyelid. It generally affects only one side of the face.

Twitches mostly resolve without any treatment. However, seek medical attention in the following conditions:

• Twitch that lasts for more than a week
• Eyelid closes completely
• Spasms which involve additional facial muscles
• Redness, swelling or discharge from the eye
• Drooping of the upper eyelid

Minor eyelid twitches can be relieved with the following methods:

• Getting adequate rest
• Refraining from alcohol, tobacco or caffeine
• Dry eyes or irritated eyes may require artificial tears to increase moisture.
• The physician might inject botulinum toxin (botox) to treat benign essential blepharospasm or hemifacial spasm. Botox provides temporary relief by paralyzing the twitching muscles. The patient should undergo repeated treatment for complete relief.
• Doctors commonly prescribe medications like clonazepam (Klonopin), lorazepam (Ativan) or trihexyphenidyl hydrochloride (Artane, Trihexane, Tritane) to treat mild cases.

There are some alternative therapies, which include:

• Biofeedback: This technique helps to control the involuntary muscle using relaxation exercises and methods.
• Acupuncture: Thin needles are inserted to the pressure points to relieve twitching
• Hypnosis
• Chiropractic measures: This technique involves hands-on spinal manipulation to heal twitching
• Diet management
• Tinted glasses or sunglasses
• As a last resort, the physician might perform a surgical myectomy, i.e., removal of muscle and nerve endings around the eyelid to relieve the spasms.