What causes eye twitching?

The eyelids are controlled by small muscles. One muscle (orbicularis oculi) closes your eyelid. Another muscle (levator palpebrae superioris) raises your eyelid. Problems with one or both may cause eye twitching. In some cases, other muscles may also cause the problem.

Many people have an eye twitch once in a while. This can happen if you're tired, have had a lot of caffeine, or are under lots of stress. Eye twitching that happens often is less common. It happens most often in women who are middle-aged or older adults.

Eye twitching that doesn't go away can be a sign of hemifacial spasm. This is a condition that causes eye twitching and sometimes twitching of other face muscles. Many times this occurs without a known cause. Your healthcare provider may want you to have an MRI to look for conditions that could irritate the facial nerve.

People may have eyelid twitching following a Bell palsy or other facial nerve problem. The movement called synkinesis comes from abnormal nerve signals.

Severe twitching of both eyes is often due to a condition called benign essential blepharospasm. Researchers aren’t sure what causes this. It may be caused by problems with a part of the brain (basal ganglia). Certain genes may cause eye twitching. In rare cases, eye twitching may be caused by a problem with the brain or nervous system such as:

• Parkinson’s disease

• Brain damage from inflammation or a stroke

• Bad reaction to certain medicines used to treat mental illness

Symptoms of eye twitching

Eye twitching varies from person to person. In most cases, only the upper eyelid twitches. Your eyelid may only partly shut, or it may fully close. You may have twitching every few seconds, or just a few times a day. Twitching may last for a few days or more, and then go away for a while. Your eye twitching may happen more often over time, and not go away. Or the symptoms may go away and not come back.

You may have other symptoms, such as:

• Eye irritation or pain

• Blinking faster

• Eyes feel sensitive to light

• Dry eyes

• Trouble seeing normally, if twitching happens often

• Spasms of facial muscles

Symptoms may go away when you sleep or focus on a difficult task. The symptoms may go away when you talk, sing, or touch another part of your body.

Diagnosing eye twitching

Your provider will ask about your medical history and your symptoms. They’ll give a physical exam. This often includes a full neurological and eye exam. A doctor who specializes in the eyes, an ophthalmologist, may diagnose you. You may not need any other tests. Or your provider may do imaging tests of your brain. These may include a computed tomography (CT) scan or an MRI. These can find other causes of eye twitch.

Treatment for eye twitching

You may not need any treatment if you don’t have severe symptoms. You may be told to get enough sleep and reduce the amount of caffeine in your diet. Or you may be given medicine to treat eye twitching. It may help reduce symptoms for a short period of time. You may also need treatment for any health condition that is causing your eye twitching, such as Parkinson’s disease.

If your eye twitching is severe, you may have a botulinum toxin shot in the muscles of your eyelids. This can paralyze the muscle that's causing the twitching. Or you may need a surgery called a myectomy. During this surgery, some of the muscles and nerves in your eyelids are removed.

Possible complications of eye twitching

If eye twitching is severe and doesn't stop, it can cause lasting (permanent) damage to your eye area. This can cause problems, such as:

• Upper eyelids that hang lower than normal, also called ptosis

• Eyebrows that hang lower than normal

• Extra skin on the upper or lower eyelid

• Eyelids that fold inward

• Muscle spasms in other parts of the body, like the jaw or neck

How to manage eye twitching

If your eyes sometimes twitch, you can take steps to reduce your symptoms. Make sure to:

• Limit caffeine

• Get enough sleep

• Reduce your stress

• Use eye drops if you have eye irritation

• Wear sunglasses when needed

When to call your healthcare provider

Call your provider right away if you have any of the following:

• Symptoms that get worse

• New symptoms, such as facial spasms or fluid from your eye