Understanding Myokymia

Eyelid twitch is also known as myokymia. It is an involuntary, and repetitive spasm of your eyelid muscles. In many cases, the twitch occurs in the upper eyelid, but sometimes, both lids may twitch.

Many people experience mild spasms and may feel a light tug on the lid.

Other people may experience a strong spasm, strong enough to cause complete closure of both eyelids. This is an entirely different condition called blepharospasm.

Spasms usually occur for a few seconds per minute or two.

Eyelid twitch is unpredictable. Myokymia may occur on and off for some days. Then it stops completely for some weeks and in some cases, months.

Eyelid twitch is harmless and painless. Most myokymias resolve on their own, so there’s no need for treatment. In rare instances, spasms of the eyelid may indicate a chronic movement disorder, especially when accompanied by facial twitches.

eyelid twitch
Photo Credit: Medical News Today

What causes eyelid twitch?

Myokymia may occur on its own, without any cause. Because they are usually not a symptom of any serious problem, the cause is not always investigated.

But that notwithstanding, eyelid twitch may be caused or worsened by:

  • A strain of the eyelid
  • Eye irritation
  • Insomnia
  • Fatigue
  • Physical exertion
  • Stress
  • As a side effect of medications
  • Use of caffeine, tobacco, or alcohol

If the spasms get worse or become chronic, you may have what is termed “benign essential blepharospasm,” – a clinical term for uncontrolled or chronic blinking or winking.

Benign essential blepharospasm affects both eyes. The main cause of this condition is not known, but spasms may be worsened by the following conditions:

  • Pinkeye or conjunctivitis
  • Inflammation of the eyelid
  • Dry eyes
  • Light sensitivity
  • Fatigue
  • Irritants like bright lights, wind, air pollution, or the sun
  • Excess alcohol
  • Stress
  • Smoking

The prevalence of benign essential blepharospasm is higher in women than in men.

A report by the Genetics Home Reference shows that at least 50,000 Americans are affected by benign essential blepharospasm and it usually develops in middle-late adulthood.

The condition may degenerate over time, eventually causing:

  • Facial spasms
  • Blurry vision
  • Hyper photosensitivity

Complications of myokymia

In rare cases, eyelid twitch may be a symptom of a nerve or brain disorder.

When myokymia results from these serious conditions, they are always accompanied by other symptoms.

Disorders of the nerve and brain that may trigger myokymia include:

  • Dystonia
  • Bell’s palsy
  • Cervical dystonia
  • Parkinson’s disease
  • Multiple sclerosis
  • Tourette’s syndrome

Eyelid twitches may also be caused by corneal scratches.

If your eye is injured, consult your ophthalmologist or optometrist immediately. Corneal scratches may damage your eyes permanently.

When does myokymia require medical care?

Most cases of myokymia are not that serious to warrant emergency medical care. But then, chronic spasms of the eyelid may be a symptom of an underlying nervous system or brain disorder.

You should see your doctor if your eyelid spasm is accompanied by any of the following symptoms:

  • Swollen or red eyelid, or unusual discharges from the eye.
  • Drooping of your upper eyelid.
  • Complete closure of your eyelid each time there’s a twitch.
  • Continuous twitching (sometimes lasting for several weeks).
  • Other parts of your face tend to be affected by the twitching.

Treatment for eyelid twitches

Most cases of myokymia resolve without treatment. If they do not resolve, you can try to decrease or eliminate the potential causes.

Myokymia is mostly caused by caffeine, fatigue, and stress.

The following tips can help to ease eye twitching:

  • Reduced caffeine intake
  • Getting enough sleep
  • Lubricating your eye surfaces with OTC eye drops or artificial tears.
  • Applying warm compresses to your eyes when a spasm starts.

Sometimes, Botox injections may help with the treatment of benign essential blepharospasm. Botox eases chronic twitches for a few months. You will need more injections as the effect wears off.

Surgery may also be used for severe cases of benign essential blepharospasm. This procedure is known as myectomy, and it involves the removal of some of the nerves and muscles of the eyelid.

How to prevent eyelid twitches

If you experience frequent eyelid spasms, then it would help to keep a journal of their occurrence.

Note your intake of tobacco, caffeine, and alcohol, as well as your stress levels and how well you’ve slept in the periods leading up to the eyelid twitching.

If your spasms happen when you don’t have adequate sleep, try sleeping 30 minutes earlier than usual to minimize the strain on your eyelids as well as the spasms.

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