Kheyali Mondal, M. Optom
Clinical Optometrist, Dr. Shroff’s Charity Eye Hospital, Delhi, India
Have you noticed your eyes twitching? These twitches may occur in either eye and can last for a few seconds to a few minutes. In some cases, they may persist much longer, this prolonged, repetitive eyelid twitching is known as eyelid myokymia. It occurs due to fine, involuntary contractions of the eyelid muscles, most often in the lower eyelid. Eyelid myokymia is generally harmless, self-limiting, and may last from seconds to hours. (1)
Epidemiology
Myokymia is commonly reported among medical students, primarily due to increased stress levels. This has led to the informal phrase “medical student disease”. (2)
Mechanism
The exact mechanism behind eyelid myokymia remains unclear. It is believed to involve irregular muscle firing, possibly originating from anomalous activity in a small motor unit located within the facial nerve nucleus in the brainstem. The orbicularis oculi muscle, responsible for eyelid closure, is the primary muscle affected. (1,2)
Factors That Can Trigger Myokymia
Ocular myokymia refers to involuntary eyelid twitching, and although the precise cause is unknown, several contributing factors have been identified. Persistent fatigue and inadequate sleep are among the most common triggers, often accompanied by increased stress and anxiety. Excessive intake of stimulants such as caffeine, along with alcohol and tobacco use, may exacerbate symptoms.
Environmental irritants, including cold weather, pollution, and dry eye, may also play a significant role. Additionally, certain medications such as topiramate, clozapine, gold salts, and flunarizine have been associated with eyelid myokymia. (1-4)
Figure 1: Causes of Myokymia
Clinical Evaluation
Fine contractions of the orbicularis oculi muscle may be observed on examination. These twitches are typically more noticeable to the patient than to the clinician. Symptoms may improve temporarily with manual retraction of the eyelid. During the evaluation, the examiner may gently retract the eyelid to assess whether the twitching reduces or worsens. (3-5)
A Few Ways to Stop Your Eye From Twitching
Most mild eyelid twitching episodes can be managed at home. The following strategies may help reduce symptoms:
- Use a warm compress: Helps relax eyelid muscles and reduce spasms.
- Reduce stress: Stress-relieving activities may lessen the frequency of twitching.
- Avoid caffeine: Gradually reduce consumption of coffee, tea, energy drinks, or soda.
- Improve sleep cycle: Adequate rest or even short power naps may help.
- Treat dry eye: Lubricating eye drops may reduce irritation-triggered twitching.
- Use eye protection: Goggles or sunglasses can shield the eyes from allergens and irritants.
Conclusion
Although occasional eye twitching is typically harmless and temporary, persistent twitching lasting more than a few weeks, difficulty opening or closing the eyes, or twitching that spreads to other areas of the face should prompt consultation with a medical professional. Early evaluation can help rule out underlying neurological or ocular conditions and provide appropriate guidance.
References
- Patel, B. C. (2023). Eyelid Myokymia. In StatPearls [Internet]. StatPearls Publishing.
- Hadžić, S., Kukić, I., & Zvorničanin, J. (2016). The prevalence of eyelid myokymia in medical students. Br J Med Res, 14(6), 1-6.
- Banik, R., & Miller, N. R. (2004). Chronic myokymia limited to the eyelid is a benign condition. Journal of Neuro-Ophthalmology, 24(4), 290-292.
- Gunes, I. B. (2024). Association Between Eyelid Twitching and Digital Screen Time, Uncorrected Refractive Error, Intraocular Pressure, and Blood Electrolyte Imbalances. Cureus, 16(9).
- Medrano-Martínez, V., et al. (2015). Eyelid myokymia in patients with migraine taking topiramate. Acta Neurologica Scandinavica, 132(2), 143-146.