Causes, Symptoms and Treatment for Eyelid Spasms

An eyelid twitch, or myokymia, is a recurring, uncontrolled spasm of the eyelid muscles. A twitch generally takes place in the upper lid, however it can happen in both the upper and lower covers.

Eyelid smasm in left eye
Eyelid smasm in left eye

For many people, these spasms are very moderate and feel like a gentle pull on the eyelid.

Others may experience a spasm strong enough to require both eyelids to close completely. This is a different condition called blepharospasm.

Spasms usually happen every couple of seconds for a minute or more.

Episodes of eyelid twitching are unpredictable. The twitch may take place off and on for a number of days. Then, you may not experience any twitching for weeks or even months.

The twitches are pain-free and harmless, however they may trouble you. The majority of spasms will resolve on their own without the requirement for treatment.

In uncommon cases, eyelid spasms might be an early warning sign of a chronic movement disorder, particularly if the spasms are accompanied by other facial twitches or unmanageable movements.

Types of Eyelid Spasms

Eye twitching in case of eye spasm
Eye twitching in case of eye spasm

The 3 most common types of eyelid spasms are eyelid twitch, essential blepharospasm, and hemifacial spasm.

Eyelid Twitch
Generally, a small unilateral spasm of your lower or upper eyelid, or sometimes both eyelids, is common, of no concern, and typically deals within a couple of days. This can be connected with a lack of sleep, tension, or excess caffeine.
Essential Blepharospasm
An involuntary condition including both eyes which begins as an increased blink rate and eventually causes a closing of the eyelids as well as squeezing of the muscles around the eyes. In many cases of essential blepharospasm, muscles of the mouth or neck likewise are involved. When these spasms occur, the uncontrolled eyelid closure may cause a momentary inability to see. Important blepharospasm is uncommon however very frustrating and often incapacitating.
Hemifacial Spasm
A condition that includes the involuntary closure of the eye in addition to muscles in the cheek, mouth, and neck, however on only one side of the face.

Symptoms of Eyelid Spasm

  • Twitching or spasm around the eyes
  • Facial spasms

The symptoms described above might not always mean that you have eyelid spasms. However, if you experience several of these symptoms, contact your ophthalmologist for a complete examination.

Main Causes of Eyelid Spasms

  • The cause of a small eyelid twitch is unknown.
  • The essential blepharospasm is focal dystonia, or unusual motion, produced by the part of the brain controlling movement. The cause of essential blepharospasm is almost never a psychiatric disease.
  • The cause of hemifacial spasm is thought to be an irregularity in the nerve to the facial muscles, which triggers the face to twitch.

Necessary blepharospasm typically takes place more frequently in females and at a later age.


A careful clinical examination identifies these conditions. Rarely, hemifacial spasm is triggered by a tumor pressing on the facial nerve, found with MRI testing.

Treatment for Eyelid Spasm

Girl with eye spasm

  • Eyelid Twitch. Minor eyelid twitches need no treatment as they usually resolve spontaneously. Reducing stress, using warm soaks, correction of any refractive mistake, and lubrication of the eye with artificial tears may help. Some eye doctors suggest minimizing caffeine use.
  • Blepharospasm. Blepharospasm can be treated with medications, biofeedback, injection of botulinum toxin, and surgery. Medications and biofeedback are seldom successful in handling blepharospasm. Botulinum toxic substance injections are now the most typically advised treatment for blepharospasm. Injection of botulinum toxic substance in tiny amounts into the muscles around the eyes will stop the spasm. The injection works for some months, however, will slowly diminish and usually has to be repeated 3 to 4 times each year. The treatment is very effective with a couple of side effects. On rare occasions when side effects occur, they include sagging of the eyelids or double vision. Side effects generally last 1 to 2 weeks while the good impacts last 3 months. Surgery to get rid of the involved muscles is occasionally needed in addition to botulinum toxic substance therapy.
  • Hemifacial Spasm. Botulinum toxin injections can ease the eyelid and facial spasms in patients with hemifacial spasm. A neurosurgical treatment for hemifacial spasm, microvascular decompression, also can eliminate the facial spasms. While it is usually effective, it is a significant neurosurgical operation, and significant issues are possible.

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