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.
Before we dive into the most common causes of eye twitching (as well as the less common causes that are more serious), let's first talk about one thing that many people think is a common cause of eye twitching but probably isn't: nutritional deficiencies.
Can Certain Vitamin Deficiencies Cause Eye Twitching? Probably Not
Some people believe that getting too much or not enough of certain vitamins or minerals can cause eyelid spasms, but this is almost never the case. The most common claims are:
Low magnesium levels can lead to muscle twitches or spasms, per the Cleveland Clinic, which could include eye twitching, although there's no research that directly links low magnesium to this specific kind of twitch.
What's more: Magnesium deficiency in otherwise healthy people is rare, per the National Institutes of Health, and common early signs include loss of appetite, fatigue, weakness, nausea and vomiting — not eyelid twitching.
Vitamin B12Limited Evidence
Low vitamin B12 (or vitamin-deficiency anemia) is another deficiency people seem to think causes eyelid twitching, but there's very limited evidence connecting the two, and the research that does exist is low-quality.
Case in point: A letter to the editor published May 2010 in Neurology India describes one 51-year-old man who had blepharospasm (uncontrollable eyelid movements, such as twitching) and was also low on vitamin B12.
This is one very limited case study, though, and doesn't prove a connection between vitamin-deficiency anemia and eye twitches.
If you're lacking B12, your symptoms are more likely to include fatigue, shortness of breath, dizziness, pale or yellowish skin, irregular heartbeat, weight loss, numbness or tingling in the hands and feet, muscle weakness, personality changes, unsteady movements and mental confusion or forgetfulness, per the Mayo Clinic.
Your body requires potassium to help conduct electrical impulses throughout your body, but potassium deficiency has not been linked to eyelid twitches.
Potassium has been suggested as a treatment for eye twitches, but there's no evidence to support it, according to the National Library of Medicine.
Many people don't get enough potassium, according to the National Institutes of Health, but when your levels are low, you're more likely to experience constipation, fatigue and muscle weakness.
Vitamin DNo Evidence
Vitamin D deficiency has not been connected to eye twitching. People who are severely deficient for a long time might experience muscle twitches, according to StatPearls, but there's no evidence to show that this includes eye twitches.
In fact, most people who are lacking in vitamin D don't have any symptoms at all.
Now that we've covered the myth of vitamin deficiencies being responsible for eye spasms, let's get into the more likely causes of twitchy eyes.
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.
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:
- De-stress (think: exercise, meditation, deep breathing)
- Eat a healthy diet full of fruits, vegetables, lean proteins and whole grains
- Log quality sleep
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.
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
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.
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
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.
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.
- Mayo Clinic: "Eye Twitching"
- Mayo Clinic: "Vitamin Deficiency Anemia"
- National Institutes of Health: "Magnesium"
- Cleveland Clinic: "10 Symptoms of a Magnesium Deficiency"
- Cleveland Clinic: "Why You Have That Pesky Eye Twitch — and When to Seek Help"
- Cedars Sinai: "Eye Twitching"
- National Institute of Neurological Disorders and Stroke: "Hemifacial Spasm"
- National Organization for Rare Disorders: "Benign Essential Blepharospasm"
- Mayo Clinic: "Blepharitis"
- American Optometric Association: "Blepharitis"
- Centers for Disease Control and Prevention: "How Much Sleep Do I Need?"
- FDA: "Spilling the Beans: How Much Caffeine is Too Much?"
- American Optometric Association: "Myokymia (eyelid twitch or tic)"
- Neurology India: "Blepharospasm and vitamin B12 deficiency"
- National Library of Medicine: "Eyelid Myokymia"
- National Institutes of Health: "Potassium"
- StatPearls: "Vitamin D Deficiency"
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.