Differential Diagnosis for One Eye Twitching

• Single most likely diagnosis
  • Benign Essential Blepharospasm: This is the most common cause of eye twitching, characterized by involuntary spasms of the eyelid muscles. It is often triggered by fatigue, stress, or caffeine.
• Other Likely diagnoses
  • Dry Eye Syndrome: Irritation and dryness of the eye can cause twitching, often accompanied by other symptoms like redness and blurred vision.
  • Eye Strain: Prolonged use of computers, reading, or other activities that cause eye fatigue can lead to twitching.
  • Caffeine or Alcohol Withdrawal: Sudden cessation of caffeine or alcohol consumption can cause eye twitching among other withdrawal symptoms.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Multiple Sclerosis: Although rare, multiple sclerosis can cause eye twitching as part of its neurological symptoms. Early diagnosis is crucial for effective management.
  • Thyroid Disorders: Both hyperthyroidism and hypothyroidism can cause muscle twitching, including the eyes, due to metabolic imbalances.
  • Neurological Disorders (e.g., Dystonia, Hemifacial Spasm): These conditions can cause involuntary muscle contractions, including eye twitching, and require prompt medical attention.
• Rare diagnoses
  • Botulism: A rare but serious illness that can cause muscle weakness, including eye twitching, due to a bacterial toxin.
  • Tardive Dyskinesia: A side effect of long-term use of neuroleptic drugs, characterized by involuntary, repetitive body movements, which can include eye twitching.
  • Myasthenia Gravis: An autoimmune disorder that can cause muscle weakness and twitching, including the eyes, due to impaired nerve-muscle communication.