From the Guidelines
Eye twitching is typically caused by stress, fatigue, excessive caffeine consumption, or eye strain from prolonged screen use, and addressing these factors can help alleviate symptoms. These factors trigger small muscle contractions in the eyelid that feel like twitching or fluttering. To address eye twitching, reduce stress through relaxation techniques, ensure adequate sleep (7-8 hours nightly), limit caffeine intake, and practice the 20-20-20 rule when using screens (look at something 20 feet away for 20 seconds every 20 minutes) 1. Applying a warm compress to the affected eye can also help relax the muscles.
Some underlying conditions, such as dry eyes, blepharitis, or neurological disorders like myasthenia gravis, can also cause eye twitching 1. Myasthenia gravis is an autoimmune disorder that affects the neuromuscular junction, causing variable weakness exacerbated by fatigue, and can manifest as ocular myasthenia gravis, affecting only the levator, orbicularis oculi, and the extraocular muscles 1. However, most eye twitches are harmless and resolve on their own within a few days.
If twitching persists beyond a week, spreads to other facial muscles, or is accompanied by redness, swelling, or discharge, consult a healthcare provider as it could indicate an underlying condition that requires medical attention 1. Recognizing the disorder and initiating appropriate workup and referral to other subspecialties, including neurology, is crucial to ensure proper medical and surgical treatment, and initiate short-term and subsequent long-term management of associated ptosis and strabismus 1.
From the FDA Drug Label
Vision Disorders: eye irritation, visual disturbance, diplopia, eye twitching, styes, visual field defect, xerophthalmia The cause of eye twitching is not explicitly stated in the drug label, but eye twitching is listed as a possible adverse event associated with clonazepam use 2.
From the Research
Possible Causes of Eye Twitching
- Eye twitching can be caused by various factors, including muscle overactivity, which can be treated with botulinum toxin therapy 3, 4, 5
- Botulinum toxin has been shown to be effective in treating dystonia, spasticity, and other disorders characterized by muscle overactivity, which may be related to eye twitching 3, 6
- Segmental craniocervical dystonia, also known as Meige syndrome, is a condition that can cause eye twitching, and has been treated with a combination of botulinum toxin, aripiprazole, and trihexyphenidyl 7
Treatment Options
- Botulinum toxin injections have been used to treat various forms of dystonia, including cervical dystonia, which can cause eye twitching 3, 4, 5, 6
- A combination of botulinum toxin, aripiprazole, and trihexyphenidyl has been shown to be effective in treating segmental craniocervical dystonia, a condition that can cause eye twitching 7
- Trihexyphenidyl has been compared to botulinum toxin in the treatment of cervical dystonia, with botulinum toxin showing greater efficacy and fewer adverse effects 6
Related Conditions
- Dystonia, a condition characterized by muscle overactivity, can cause eye twitching and has been treated with botulinum toxin therapy 3, 4, 5, 6
- Segmental craniocervical dystonia, also known as Meige syndrome, is a condition that can cause eye twitching and has been treated with a combination of botulinum toxin, aripiprazole, and trihexyphenidyl 7