What are the causes of blepharospasm (eye twitching)?

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From the Guidelines

Eye twitching is most commonly caused by stress, fatigue, excessive caffeine intake, or eye strain from prolonged screen use, and can also be triggered by underlying conditions such as blepharitis, dry eyes, allergies, and nutritional imbalances, as noted in recent studies 1. The causes of eye twitching can be multifaceted, including:

  • Stress and fatigue, which can trigger small muscle contractions in the eyelid
  • Excessive caffeine intake, which can stimulate the nervous system and lead to muscle twitching
  • Eye strain from prolonged screen use, which can cause dry eyes and irritation
  • Underlying conditions such as blepharitis, which can lead to ocular surface inflammation and exacerbate symptoms of eye irritation
  • Dry eyes, allergies, and nutritional imbalances, particularly magnesium deficiency, which can contribute to eye twitching In most cases, eye twitching resolves on its own within a few days by addressing these underlying factors. Some key points to consider in managing eye twitching include:
  • Getting adequate sleep to reduce fatigue and stress
  • Reducing caffeine and alcohol intake to minimize stimulation of the nervous system
  • Using artificial tears for dry eyes to alleviate irritation and discomfort
  • Taking regular breaks from screens to reduce eye strain
  • Practicing stress-reduction techniques like deep breathing or meditation to manage stress and anxiety While usually harmless, persistent twitching lasting more than a week, twitching affecting other facial muscles, or eyelid drooping warrant medical attention, as they could indicate more serious conditions like blepharospasm, hemifacial spasm, or neurological disorders, as discussed in recent studies 1.

From the Research

Causes of Eye Twitching

  • Eye twitching can be caused by various factors, including blepharospasm, a syndrome characterized by excessive or continuous eye closure related to overactivity of the orbicularis oculi and adjacent muscles bilaterally 2.
  • Hemifacial spasm, a peripherally-induced movement disorder typically caused by vascular compression of cranial nerve VII (CN VII), can also lead to involuntary unilateral contractions of muscles used in facial expression, including eye twitching 2.
  • Parkinson's disease (PD) has been linked to eye twitching, with some patients experiencing blepharospasm as a manifestation of peak of dose dyskinesia in PD 3.
  • Apraxia of eyelid opening (AEO) has also been reported in patients with parkinsonism, and is more frequently observed in atypical parkinsonism than in idiopathic Parkinson's disease (IPD) 4.
  • The development of Parkinson's disease has been evaluated in patients with blepharospasm, and results suggest that patients with idiopathic blepharospasm (IBS) are more prone to develop parkinsonian symptoms 5.
  • However, the relationship between Parkinson's disease and hemifacial spasm is still being explored, and one study found no significant increased risk of hemifacial spasm amongst the general PD population 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Botulinum toxin in the treatment of blepharospasm and hemifacial spasm.

Journal of neural transmission (Vienna, Austria : 1996), 2008

Research

Development of Parkinson's disease in patients with blepharospasm.

Movement disorders : official journal of the Movement Disorder Society, 2004

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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