What Is a Twitching Eye a Sign Of?

Eye twitching or eyelid spasms are usually harmless and temporary. Avoid caffeine and stress and get plenty of sleep to get rid of an eye twitch.

Eye twitching (blepharospasm) is an abnormal, involuntary blinking or spasm of the eyelids.

Most of the time eye twitches are harmless, but in some cases, they may be a sign of a problem with the nervous system. 

Benign essential blepharospasm (BEB) is a form of eye twitching that is a progressive neurological disorder.

Symptoms of eye twitching (blepharospasm) include: 

• Spasm of the eyelids
• Involuntary eyelid closure
• Gradual increase in blinking
• Eye irritation
• Fatigue
• Emotional tension
• Sensitivity to bright light
• Symptoms become more frequent as the condition progresses in benign essential blepharospasm (BEB)
• Facial spasms may develop in BEB

Eye twitching may lessen or stop when a person is concentrating on a specific task or sleeping.

The cause of eye twitching (blepharospasm) is unknown but is thought to be due to an abnormal function of the basal ganglion, the part of the brain responsible for controlling muscles. 

In rare cases, genetics may play a role in the development of blepharospasm.

Eye twitching may be a sign of some conditions that usually go away on their own such as: 

• Consumption of caffeine or other stimulants
• Stress or anxiety (“nervous ticks”)
• Lack of sleep
• Nicotine from smoking and tobacco use
• Eye irritation or dryness 
• Physical activity due to accumulation of lactic acid (lactic acidosis) or electrolyte deficiency
• Nutrient deficiencies such as vitamin D, vitamin B, and calcium
• Dehydration
• Side effects of medications such as corticosteroids, estrogen pills, diuretics, antidepressants, some seizure medications, and certain drugs used to treat psychosis 

There are no laboratory tests needed to make a definitive diagnosis of benign essential blepharospasm. A diagnosis is made based on the patient history and a physical exam.

For less serious and often temporary causes of muscle twitching, no treatment may be needed and twitching will usually go away on its own. If treatment is needed, it may include:

• Consumption of caffeine or other stimulants
• Reduce or avoid caffeine or stimulant use 
• Stress or anxiety (“nervous ticks”)
• Practice stress reduction techniques such as mediation, deep breathing, or yoga
• Lack of sleep
• Try to maintain good hygiene and get adequate sleep
• Nicotine from smoking and tobacco use
• Don’t smoke or use tobacco
• Eye irritation or dryness 
• If there is no underlying medical condition causing eye irritation or dryness, lubricating eye drops may help
• Physical activity due 
• Accumulation of lactic acid (lactic acidosis) 
• Reduce intensity or duration of exercise
• Get adequate fluid intake 
• Rest
• Electrolyte deficiency
• Drink enough water while exercising
• Consume coconut water or sports drinks with electrolytes
• Nutrient deficiencies such as vitamin D, vitamin B, and calcium
• Dietary modifications or nutritional supplements
• Dehydration
• Increase water intake
• Side effects of medications such as corticosteroids, estrogen pills, diuretics, antidepressants, some seizure medications, and certain drugs used to treat psychosis
• Talk to your doctor about changing to another medication that may not cause the side effects
• Do not stop taking any medications without first talking to your doctor
   

There is no cure for benign essential blepharospasm (BEB) but there are treatments that can reduce its severity, such as:

• Oculinum (botulinum toxin, or Botox) injection into the muscles of the eyelids 
• Medications 
  • Symptom relief is usually short term 
  • Medicines are only helpful in about 15% of cases
    • Anticholinergics
    • Benzodiazepines
    • GABAB receptor agonists
    • Dopamine receptor agonists
    • Neuroleptics
    • Monoamine depleters
    • Anticonvulsants
    • Imidazopyridines
    • Atypical antipsychotics
    • Serotonin receptor antagonists
    • Antiarrhythmics
• Surgery
  • Myectomy: removes some of the muscles and nerves of the eyelids and improves symptoms in 75 to 85% of patients
• Alternative therapies (not proven)
  • Biofeedback
  • Acupuncture
  • Hypnosis
  • Chiropractic
  • Nutritional therapy