At the beginning of December, my right upper eyelid started twitching. I didn't think much of it because it usually happens to my lower lid occasionally and goes away within a day or two. Well this one didn't. In fact, after a certain amount of time, the twitching spread to the side of the bridge of my nose and has since spread further down the side of my nose. Sometimes I can feel it underneath my eye too but above my cheeck. The lid and the nose twitch do not coincide. The lid usually happens on a daily basis, the nose part is intermittent and can skip two or three days at a time. Sometimes the lid twitching causes my eye to stay about 1/4 of the way shut but does not last more than 30 seconds.
I went to an opthalmologist at the end of December. He noticed slight inflammation under the lid and prescribed tobramycin for two weeks. When I returned for a follow up, he stated that the inflammation had cleared up. He told me to stop taking the tobramycin and use systane drops three times a day and come back in a year. He also suggested I cut back on coffee (my ONE cup a day??) and reduce stress in my life. Ha!
Since that time, I have noticed that the nose spasms are usually related to a change in lighting (dark to bright) or like a camera flash. Occasionally I wear contacts and the eyelid twitch becomes worse and my eye tends to become half closed. Occasionally it feels like there is something under my lid closer to my nose. And I hate those systane drops because the sting a little and make my vision blury.
After doing some research, I see two things: either it's nothing or it's neurological which is very rare. I don't see anything about the change in lighting setting it off.
Since it is expensive for me to go to the doctor, I was wondering if someone had a suggestion as to what to do next. Second opinion? Give it more time? See a neurologist?
Any suggestions or information would be appreciated!
The most common cause of twitching is ocular surface problems. The most common ocular surface problem is dry eye syndrome. Use preservative free tears (systane and other brands available) several times daily. Add a good Omega 3 to your supplements or diet. Recommend good lid hygiene like hot compresses and cleaning the eyelashes with baby shampoo. Give this several weeks and if possible avoid contacts because they may exacerbate the issue. If this doesn't cure, then its possibly essential blepharospasm. Botox can work on this quickly. Good luck!
Timothy D. McGarity, M.D.
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