From the Guidelines
Eyelid twitching, medically known as myokymia, is typically a benign condition caused by fatigue, stress, excessive caffeine intake, or eye strain, and most cases resolve on their own with rest, stress reduction, and limiting caffeine consumption. However, persistent or severe eyelid twitching may indicate more serious conditions such as blepharospasm (involuntary muscle contractions), hemifacial spasm (affecting one side of the face), or rarely, neurological disorders like Parkinson's disease or multiple sclerosis. Dry eyes, eye irritation, or nutritional deficiencies (particularly magnesium) can also trigger twitching. If the twitching persists beyond a few days, spreads to other facial muscles, causes the eye to close completely, or is accompanied by other symptoms like facial weakness or vision changes, medical attention should be sought. Treatment depends on the underlying cause but may include artificial tears for dry eyes, botulinum toxin injections for blepharospasm, or addressing nutritional deficiencies. The twitching occurs because the small muscles controlling eyelid movement experience irregular nerve firing, causing involuntary contractions that are usually harmless but can be annoying. According to the most recent study 1, warm compresses and eyelid cleansing may provide symptomatic relief for both anterior and posterior blepharitis, which can be associated with eyelid twitching.
Some key points to consider:
- Eyelid twitching can be a symptom of various conditions, including blepharitis, which is a chronic inflammation of the eyelids 1.
- Treatment for blepharitis may include warm compresses, eyelid cleansing, and topical antibiotics, which can help alleviate symptoms of eyelid twitching 1.
- In some cases, oral antibiotics or oral tetracyclines may be prescribed to treat underlying conditions that may be contributing to eyelid twitching 1.
- It is essential to consult a healthcare professional if eyelid twitching persists or is accompanied by other symptoms, as it may indicate a more serious underlying condition 1.
Overall, while eyelid twitching is usually a benign condition, it is crucial to seek medical attention if it persists or is accompanied by other symptoms, as it may indicate a more serious underlying condition that requires proper diagnosis and treatment.
From the Research
Eyelid Twitching
- Eyelid twitching can be a sign of blepharospasm, a focal dystonia characterized by excessive or continuous eye closure related to overactivity of the orbicularis oculi and adjacent muscles bilaterally 2
- Blepharospasm is a disabling disorder that can cause chronic, intermittent, or persistent involuntary eyelid closure due to spasmodic contractions of the orbicularis oculi muscles 3
- Botulinum toxin type A (BtA) is considered the first line of therapy for blepharospasm and has been shown to result in a moderate to large improvement in blepharospasm-specific severity and disability 3
Causes and Treatment
- Blepharospasm can be caused by a variety of factors, including vascular compression of cranial nerve VII (CN VII) leading to involuntary unilateral contractions of muscles used in facial expression 2
- Botulinum toxin is the treatment of choice for blepharospasm and hemifacial spasm, with a high response rate and tolerable safety profile 4, 2, 5
- BtA has been shown to be effective in reducing blepharospasm-specific severity and disability, with a reduction of 0.93 points on the Jankovic Rating Scale (JRS) severity subscale at four to six weeks after injection 3
Diagnosis and Evaluation
- The diagnosis of blepharospasm is typically made based on clinical evaluation and rating scales, such as the Jankovic Rating Scale (JRS) 6, 3
- The JRS includes subscales for severity and disability, and is used to evaluate the effectiveness of treatment for blepharospasm 6, 3
- Current scales used to evaluate blepharospasm may not be sensitive enough to differentiate between different botulinum toxins or to capture all relevant aspects of the disorder 6