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Eye Care Archive (Expert Forum)
Eye twitch
Our Ask A Doctor Ophthalmology Forum is where you can post your question and receive a personal answer from physicians affiliated with the American Academy of Ophthalmology.
Eye twitch
by christophage, Dec 24, 2006 12:00AM
On Tuesday the 19th of December, I realized that my lower eyelid of my right eye was having spasms. I dismissed it, but realized when it went on for the rest of the day that it was different from a usual twitch. Since then it has not yet stopped twitching. At first someone suggested that it was because I haven't been sleeping right but since then I have started getting my sleep and it still twitches. I have also been under an incredible amount of stress over the past few months; I'm not sure if that would have anything to do with this... What causes this? How could I treat it?
Doctor's Answer
by Forum-OD-MP, Dec 25, 2006 12:00AM
there are 2 fairly common causes of eyelid twitching/spasm.
1) MYOKYMIA: caused by lack of sleep, stress, caffeine and other not-well-understood factors. sometimes people just get it for no apparent reason ("idiopathic" myokymia). it can be helped by warm compresses and topical (eyedrop) and oral antihistamines as well as obviously less stress and more sleep. coincidently, i myself have been suffering from this for about 2 weeks! so i know exactly how annoying it can be. it goes away when i use a Rx topical antihistamine (i use optivar), but it comes back a few hrs later. very annoying. i have definitely been losing sleep and having extra stress, so i know the cause of my own suffering. anyway, i digress. the vast majority of people who complain of "twitching" eyelid(s) have this temporary and totally benign (although admittedly irritating!) condition. differentiated from "blepharospasm" because myokymia is intermittent. it comes and goes.
2) BLEPHAROSPASM: constant facial muscle spasm caused by facial cranial nerve damage. differentiated from benign myokymia b/c it "twitches" ALL THE TIME. literally 24/7 twitching that never stops, not even for a few minutes. the facial cranial nerve damage can have many causes...virus, neurological disorders like myasthenia gravis, trauma and others. it usually is not limited to "just an eyelid"...it usually involves other facial muscles like cheek and "eyebrow" muscles (orbicularis oculi). it is not solvable with any topical or oral treatment...it usually requires BOTOX injections 4-5 times a year to keep it under control.
the most likely scenario for what you describe is MYOKYMIA. it can last for weeks...trust me i know. even when you do everything right and increase your sleep and decrease stress/caffeine/etc. good luck!
1) MYOKYMIA: caused by lack of sleep, stress, caffeine and other not-well-understood factors. sometimes people just get it for no apparent reason ("idiopathic" myokymia). it can be helped by warm compresses and topical (eyedrop) and oral antihistamines as well as obviously less stress and more sleep. coincidently, i myself have been suffering from this for about 2 weeks! so i know exactly how annoying it can be. it goes away when i use a Rx topical antihistamine (i use optivar), but it comes back a few hrs later. very annoying. i have definitely been losing sleep and having extra stress, so i know the cause of my own suffering. anyway, i digress. the vast majority of people who complain of "twitching" eyelid(s) have this temporary and totally benign (although admittedly irritating!) condition. differentiated from "blepharospasm" because myokymia is intermittent. it comes and goes.
2) BLEPHAROSPASM: constant facial muscle spasm caused by facial cranial nerve damage. differentiated from benign myokymia b/c it "twitches" ALL THE TIME. literally 24/7 twitching that never stops, not even for a few minutes. the facial cranial nerve damage can have many causes...virus, neurological disorders like myasthenia gravis, trauma and others. it usually is not limited to "just an eyelid"...it usually involves other facial muscles like cheek and "eyebrow" muscles (orbicularis oculi). it is not solvable with any topical or oral treatment...it usually requires BOTOX injections 4-5 times a year to keep it under control.
the most likely scenario for what you describe is MYOKYMIA. it can last for weeks...trust me i know. even when you do everything right and increase your sleep and decrease stress/caffeine/etc. good luck!
Member Comments (1)
by christophage, Dec 25, 2006 12:00AM
Ohhh I see. That sounds like me. Hopefully it will go away soon, it sure is annoying. Thanks for the advice, glad it's nothing serious.
by vagee, Oct 19, 2008 09:07AM
A related discussion, laser instead of eye surgery was started.
by Deb1023, Aug 24, 2009 10:59PM
A related discussion, Can Vistaril use & stress cause blepharospasm? was started.
