From the Guidelines
Blepharospasm, or eyelid twitching, is typically caused by fatigue, as evident in variable incomitant strabismus where ptosis worsens with fatigue 1. The causes of blepharospasm can be multifactorial, but the most recent and highest quality study suggests that fatigue plays a significant role in its development.
- Fatigue can exacerbate ptosis, which is often associated with blepharospasm
- Prolonged upgaze can worsen ptosis, and the Cogan lid-twitch sign may be present
- Other factors such as stress, excessive caffeine consumption, or eye strain from prolonged screen use may also contribute to eyelid twitching However, it is essential to note that the study by 1 provides the most recent and highest quality evidence, and its findings should be prioritized when determining the causes of blepharospasm. In real-life clinical practice, it is crucial to consider the potential underlying conditions that may cause persistent twitching, such as blepharospasm or hemifacial spasm, and to evaluate these conditions promptly to prevent morbidity and mortality.
- A thorough medical evaluation is necessary to rule out any underlying conditions that may require medical attention
- Reducing stress, ensuring adequate sleep, limiting caffeine intake, and taking regular breaks from screens can help alleviate eyelid twitching symptoms
- Applying a warm compress to the affected eye may also help relax the muscles and reduce twitching.
From the Research
Causes of Blepharospasm (Eyelid Twitch)
- Benign eyelid twitching can be caused by stress, fatigue, and caffeine consumption 2
- Prolonged digital screen time may play a role in the development of eyelid myokymia (EM) 2
- Facial nerve neuropathy can be a cause of chronic eyelid twitching (CET) 3
- Underlying brainstem disease, such as multiple sclerosis, can be a cause of eyelid myokymia 4, 5
- Cold weather may be a contributing factor to the development of CET, with 61.27% of cases occurring in cold weather 3
- Electrophysiological studies have shown that conduction defects in the facial nerve pathway can be a cause of CET, with delayed or absent R2 response in blink reflex and prolonged facial nerve latency 3
- Gender differences may also play a role, with women being more vulnerable to CET than men (female to male: 3 to 1) 3