Eye Twitching: Types, Causes and Treatment

Key takeaways:

  • Eye twitching is the involuntary movement of eyelids, eye muscles or eyes.
  • Eye twitching may be myokymia, benign essential blepharospasm, hemifacial spasm, benign fasciculation, or nystagmus.
  • Treatment will vary according to cause, so consult your doctor if you have severe or persistent eye twitching.

Why is my left eye twitching? From our experience at our eye clinic, occasional eye twitching is a fairly common occurrence, and typically shouldn’t be a cause for alarm. That said, if it bothers you, is impeding your vision, or has been going on for a long time, it’s best to book an appointment with an ophthalmologist.

What Is Eye Twitching?

Eye twitching refers to involuntary movements or spasms of the eyelid, eyes or eye muscles. It can manifest in different ways, including the following:

  • Abnormally frequent, uncontrolled blinking
  • Eyelid flutters or tics
  • Barely perceptible muscle spasms around the eyes

Eye Twitching Types and Causes

You can classify eye twitching into several categories. The following are the different types of eye twitching.

1. Eyelid or Ocular Myokymia

Myokymia is the twitching of the eyelid on one eye, particularly the lower eyelid. The movements are typically small, slow and rhythmic. Myokymia is a common type of eye twitching and does not usually require treatment.

What Causes Myokymia?

Myokymia is usually associated with lifestyle factors. Stress, fatigue, lack of sleep, dry eyes, and eyestrain are primary causes. Poor nutrition, excessive alcohol or caffeine intake, too much smoking, and antipsychotic medications may also cause eyelid tics. Exposure to bright light and air pollution may also lead to myokymia.

However, in some rare instances, myokymia may be a symptom of a systemic disease like Guillain-Barre syndrome and multiple sclerosis.

2. Benign Essential Blepharospasm

Benign essential blepharospasm (BEB) causes the eyes to squeeze shut. BEB may also cause involuntary squinting and winking.

BEB can be more disruptive than myokymia. The sudden, forceful eyelid movements can even render a person functionally blind.

In fact, severe blepharospasm may force the eyelids closed, and an episode can last for hours. This is why people diagnosed with BEB may have to give up crucial activities like driving and professional sports that require keen focus and clear eyesight.

BEB can happen to anyone, including men and women of all ages. However, it appears to be more common among middle-aged and older women.

What Causes Benign Essential Blepharospasm?

It is not clear what causes benign essential blepharospasm. However, research indicates BEB may be due to an abnormality in the basal ganglia’s electrical activity. The basal ganglia is a cluster of brain structures that regulates the signals that regulate your body’s movement.

3. Hemifacial Spasm

Hemifacial spasm, a condition of the nervous system, presents as muscle spasms on one side of the face. Thus, the right eye twitching for a female is most likely a hemifacial spasm if unaccompanied by left eye twitching. For a female with benign essential blepharospasm, there is likely to be bilateral twitching – i.e., both eyes are affected.

What Causes Hemifacial Spasm?

The twitching of the muscles (including the eye muscles) on one side of the face is caused by facial nerve compression. This is commonly due to a pulsing blood vessel touching the nerve, but the compression may also be because of a tumour. Aside from nerve compression, facial nerve injury is also a potential cause of hemifacial spasms.

In some cases, muscle movements in the face may lead to a hemifacial spasm. Anxiety, stress and fatigue may also trigger the condition.

4. Benign Fasciculation Syndrome

Tics in and around the eyelids may indicate benign fasciculation syndrome (BFS). Fasciculations are small and fast, and the twitches are barely discernible.

What Causes Benign Fasciculation Syndrome?

Overactivity in the nerve controlling the twitching eye muscle is the typical cause of eye muscle fasciculations. However, the exact cause of benign fasciculation syndrome is unknown. That said, BFS is associated with stress, sleep deprivation, alcohol, caffeine, taxing physical exercises, hyperthyroidism, and a recent viral infection.

5. Nystagmus

Nystagmus is a condition characterised by uncontrolled eye movements; the eyes look like they’re shaking or vibrating. The movements can be fast or slow, noticeable or undetectable, and may be horizontal, vertical or circular. Unlike other types, nystagmus involves the fluttering of the eyes themselves.

What Causes Nystagmus?

Nystagmus is typically caused by a congenital or early-childhood-onset neurological issue. Adult-onset nystagmus is usually caused by physical trauma, a stroke or a condition like multiple sclerosis.

Nystagmus has other possible causes, such as a high degree of myopia and astigmatism. The increased eye pressure due to glaucoma may also cause the eyes to shake. Inflammation of the inner ear, medications, and diseases of the central nervous system may also cause nystagmus.

Eye Twitching Treatment

The occasional myokymia usually does not require treatment. Treatment may also be not indicated when eye twitching is caused by stress, fatigue, lack of sleep, pollution, etc. These instances call for lifestyle intervention or changes more than treatment.

For severe or persistent eye twitching, the range of potential treatments includes:

  • Oral drug therapy
  • Botulinum toxin (Botox) injections
  • Surgery (e.g., to remove eyelid muscle, remove tumours, decompress nerves, resolve nerve injury, etc.)

Consult Your Doctor

If you are experiencing severe eye twitching or have had it for an extended period, consult an ophthalmologist. Your eye doctor will conduct tests and refer you to other specialists, as needed, to find the underlying cause of your eye tics.

Knowing why your eyes are twitching is critical to treating them, as the treatment method will change depending on the cause. For instance, if severe myopia is causing your eyes to shake, perhaps addressing the refractive error through phakic intraocular lens implantation may resolve your nystagmus – or it may not. These are questions best left to medical experts to explore.

Gulf Family Clinic is a leading eye clinic in Dubai. We have expert doctors and use state-of-the-art equipment and advanced techniques to provide therapeutic and specialist eye care services for children and adults. Schedule an appointment to get your eye twitching checked.