From the Guidelines
Blepharospasm, or eye twitching, in adults is most commonly caused by benign essential blepharospasm, a condition characterized by involuntary muscle contractions in the eyelid, but can also be associated with underlying conditions such as myasthenia gravis, thyroid eye disease, or other neurological disorders. The exact cause of blepharospasm can vary, but it is often triggered by factors such as stress, fatigue, or eye strain. According to the study by 1, myasthenia gravis is an autoimmune disorder that can cause variable weakness, including ocular features, and can be a potential underlying cause of blepharospasm.
To address blepharospasm, it is essential to identify and manage any underlying conditions. In some cases, blepharospasm may be related to thyroid eye disease, an autoimmune disorder characterized by congestion and inflammation of the orbit and surrounding tissues, as described in the study by 1. However, the most recent and highest quality study, 1, suggests that myasthenia gravis is a critical consideration in the diagnosis and management of blepharospasm.
Key considerations for managing blepharospasm include:
- Reducing stress through relaxation techniques
- Ensuring adequate sleep (7-8 hours nightly)
- Limiting caffeine intake to less than 400mg daily
- Taking regular breaks from screens using the 20-20-20 rule (look at something 20 feet away for 20 seconds every 20 minutes)
- Using artificial tears if the eyes feel dry
- Consulting a healthcare provider if twitching persists beyond two weeks, spreads to other facial muscles, causes the eyelid to close completely, or is accompanied by other symptoms.
In rare cases, persistent eye twitching may require specific treatments such as botulinum toxin injections or medications, as indicated by the study by 1. It is crucial to prioritize the diagnosis and management of underlying conditions, such as myasthenia gravis, to ensure optimal outcomes in terms of morbidity, mortality, and quality of life.
From the Research
Causes of Blepharospasm (Eye Twitching) in Adults
- Blepharospasm, or eye twitching, can be caused by various factors, including:
- Digital screen time: A study published in 2024 found a strong positive correlation between the duration of eyelid twitching and the time spent in front of digital screens 2.
- Stress, fatigue, and caffeine consumption: Previous studies have shown that these factors can contribute to isolated eyelid myokymia (EM) 2.
- Neurological disorders: Tourette syndrome, a stress-sensitive neurologic disorder, can also cause eye twitching and other eye-related symptoms 3.
- Other potential causes of eye twitching include:
- Caffeine: A 2017 study found that caffeine can increase the velocity of rapid eye movements in unfatigued humans 4.
- Alcohol consumption: A 2023 study found that dietary alcohol consumption can elicit corneal toxicity through the generation of cellular oxidative stress, which may contribute to eye twitching 5.
- However, some studies have found no significant correlation between eye twitching and other factors, such as:
- Uncorrected refractive error, glaucoma, or blood electrolyte levels 2.