It's hard to ignore a pesky eye twitch: No matter if it continues on and off for several days or lasts just a couple of hours, the involuntary movement is distracting, to say the least. And you may be concerned about what's causing it.
"Eyelid twitching is generally due to the activation of a nerve ending in the eyelid," says Lisa Park, MD, an ophthalmologist at ColumbiaDoctors and associate professor of ophthalmology at Columbia University Irving Medical Center in New York City.
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Usually it's temporary, affecting the lower eyelid in one eye, per the American Optometric Association (AOA), and it's typically nothing to worry about. But frequent or severe twitching may point to an underlying health condition.
Here's what might be going on.
1. It's Your Lifestyle
The most likely reasons behind eye twitching (aka ocular myokymia) are no big deal. "The majority of eyelid twitching is minor and benign," Dr. Park says.
Common triggers include:
- Excessive caffeine: The definition of "too much" caffeine varies a bit from person to person, but the FDA recommends limiting caffeine to 400 mg per day, or four to five cups of home-brewed coffee. And remember, caffeine can come from other sources, too, including energy drinks, soda, chocolate, tea and certain medications. Often, increased caffeine intake goes hand-in-hand with fatigue and stress, two other factors commonly involved in sudden eyelid twitches.
- Fatigue: Adults should be getting between seven and nine hours of sleep each night, per the Centers for Disease Control and Prevention.
- Stress: This includes life stressors like work responsibilities but also things that stress your body, like poor nutrition or lack of sleep, per the AOA.
- Eye strain or irritation: This could be caused by things like bright light, smoking, wind or air pollution.
Fix it: In these cases, the twitching likely will last a short amount of time and should go away once you limit the triggers, Dr. Park says. In other words, twitching generally resolves itself if you:
If it doesn't, Botox may help.
"Botox can be injected in very small quantities into the muscles around the eye to relieve spasms," Dr. Park says. "It blocks the nerve-signaling process."
She adds that the effect is temporary, though, and only lasts a few months.
Can Certain Vitamin Deficiencies Cause Eye Twitching?
Some people believe that getting too much or not enough of certain vitamins or minerals can cause eyelid spasms. The most common are:
- Vitamin D: Low or high levels of vitamin D have not been connected to eye twitching.
- Potassium: Your body requires potassium to help conduct electrical impulses throughout your body, but neither high nor low levels of potassium have been directly linked to eyelid twitches.
- Magnesium: This one gets a maybe. Low magnesium levels can lead to muscle twitches, which could include eye twitching. While there's no research to say for sure, it doesn't hurt to add some healthy foods high in magnesium to your diet, such as spinach, lima and black beans, quinoa, flaxseeds, lentils and brown rice. You could also try an electrolyte drink that includes magnesium.
2. It's Blepharitis
Bothersome eye twitching could indicate you have blepharitis, which is inflammation of the eyelids caused by bacteria or a skin condition such as dandruff or rosacea, according to the AOA.
With blepharitis, you may also experience these other symptoms:
- A burning sensation in your eyes
- Red and swollen eyelids
- Dry eyes
- Crusty eyelids
Fix it: If the underlying cause is a bacterial infection, an antibiotic may be prescribed for treatment. Otherwise, the treatment goal will be to keep the eyelids crust-free by gently scrubbing the eyelids. You'll likely have to build it into your routine, as blepharitis doesn't usually go away completely, per the Mayo Clinic.
3. You Have Benign Essential Blepharospasm
"This is a rare neurological disorder where there is involuntary spasms of the eyelid associated with muscle contractions," Dr. Park says. "It usually causes the eye to close or blink uncontrollably."
Most often, it'll affect both eyes and can be accompanied by jaw clenching, grimacing and tongue protrusion, according to the National Organization for Rare Disorders.
Fix it: Treatment options include oral medications, Botox injections and in severe cases, surgery to remove the eyelid muscle.
4. You Have a Neurological Issue
In rare cases, eye twitching can signal an underlying problem with your brain or nervous system, according to the Mayo Clinic, such as:
- Bell's palsy
- Cervical dystonia or dystonia
- Multiple sclerosis
- Oromandibular dystonia and facial dystonia
- Parkinson's disease
- Tourette syndrome
Fix it: Dr. Park says the twitching alone is unlikely to be due to a neurologic condition, but you should see a doctor if you also have any of the following symptoms:
- Muscle spasm (where the upper eyelid droops or the eyelid closes completely, or other parts of the face including the mouth are involved)
- Eyelid swelling or redness of the eye
- Changes in vision, such as double vision
5. It's a Hemifacial Spasm
Eye twitching can be the first sign of a hemifacial spasm, which is a neuromuscular disorder that involves spasms on one side of the face, according to the National Institute of Neurological Disorders and Stroke.
It can eventually lead to a forced closure of the eyelid or pull the mouth to one side. It's oftentimes caused by a blood vessel pressing on the facial nerve, usually as a result of a facial nerve injury or a tumor.
Fix it: Treatment options include Botox injections or surgery to relieve pressure on the facial nerve.
What to Do if Your Eye Is Twitching
Oftentimes, the twitching will go away if you're sleeping, in deep concentration or engaged in an activity such as singing, talking or touching another part of your body, according to Cedars Sinai. In most cases, it'll resolve on its own without a need for treatment.
But if it doesn't go away, it's a good idea to schedule an appointment with an eye doctor. Dr. Park says you should seek help if:
- The twitching lasts longer than a week
- The eyelid droops or closes involuntarily
- You have changes in vision or double vision
- The twitching involves the face or mouth
The Cleveland Clinic also recommends seeing a doctor if:
- It feels like there's something in your eye
- You become sensitive to light
- Your eyes look red
Dr. Park says your doctor may order imaging, such as a CT scan, to further evaluate the issue and figure out what's going on.
Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.