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Eye Twitching

What Is an Eyelid Spasm

         Three most commonly seen types of eyelid spasms are hemifacial spasm, eyelid twitch and essential blepharospasm.

Eyelid Twitch Typically a unilateral (involving only one eye) slight spasm (involuntary muscle movement) of your lower or upper eyelid, or sometimes both the eyelids, is not in common, of not a high concern, and usually gets resolved in a few days. This might be associated with insomnia, stress, or an excess of caffeine intake.

Essential Blepharospasm An involuntary(out of your control) condition involving both eyes which starts as an increase in blink rate which eventually leads to the closing of the eyelids as well as squeezing of the muscles around the eyes. In some cases of essential blepharospasm, muscles of the mouth or neck are also seen to be involved. As these spasms occur, the involuntary eyelid closure is known to cause a temporary inability to see. Essential blepharospasm although rare, but is very troublesome and often incapacitates an individual.

Hemifacial Spasm A condition that involves involuntary closure of the eye along with twitching muscles in the cheek, mouth, and neck, but only on one side of the face.

SymptomsTwitching or spasm around the eyes Facial spasms The symptoms described above do not necessarily mean that you have eyelid spasms. However, if you observe one or more of these symptoms, contact your ophthalmologist (yes, that’s what you call an eye doctor!) for a complete exam.

Causes The causes of minor eyelid twitch are unknown. The essential blepharospasm is an abnormal movement, produced by the part of the brain that is responsible for controlling movement. The cause of essential blepharospasm very rarely turns out to be a psychiatric disease. The cause of hemifacial spasm is generally thought to be an abnormality in the Optic nerve to the facial muscles, which causes twitching in the face.

Risk Factors

         Essential blepharospasm is known to occur more commonly in females and that too at their later age.

Tests and Diagnosis These conditions can be easily distinguished by a careful clinical examination. Sometimes, hemifacial spasm is known to be caused by a tumour pressing on the facial nerve, which can be found with the help of MRI testing.

Treatment and Drugs Eyelid TwitchMinor eyelid twitches require no treatment as they usually resolve spontaneously. Reducing stress, using warm soaks, correction of any refractive error, and lubrication of the eye with artificial tears may help. Some ophthalmologists recommend reducing caffeine usage.

  BlepharospasmBlepharospasm can be treated most effectively with medications, biofeedback, and injections of botulinum toxin, or surgery. Medications and biofeedback are very rarely successful in managing blepharospasm. Botulinum toxin injections are now the most widely recommended and used treatment for blepharospasm. Injection of botulinum toxin in very small quantities into the muscles around the eyes is known to stop the spasm. The injection works for several months but will slowly wear off and the process needs to be repeated 3 to 4 times each year. The treatment is very successful with very few side effects. On rare occasions when side effects do occur, they might include drooping of the eyelids or double vision. Side effects typically last for 1 to 2 weeks while the good effects are known to last 3 months. Surgery to remove the involved muscles is occasionally needed in addition to botulinum toxin therapy.

Hemifacial SpasmBotulinum toxin injections can relieve the eyelid and facial spasms in patients who experience hemifacial spasms. A neurosurgical procedure for hemifacial spasm, microvascular decompression, also can be used to relieve the facial spasms. While it is generally successful, it is a major neurosurgical operation and serious complications are possible if the surgeon lacks proper training and experience.

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