The Twitching Eyelid: Is it a Lucky Sign ?

  

  So your right eye started to twitch lately, and you were told that it’s a   sign of a good news. More money, or maybe more success right ?! Well, it could be the reverse. A twitching eyelid, also known as myokimia, is an involuntary activity, and may serve as an early indicator of a variety of medical problems.                                              

What causes Eyelid twitching?                                                       

Eyelid twitching simply means that the muscles under your eyelid skin are contracting. Normally, they contract only under your voluntary control. In myokimia, they begin to fire on their own. The commonest causes of occasional twitch that may persist for a few days are insufficient sleep, stress, altered sleep cycles such as time zone travels, and night time jobs (several IT professionals are at risk). A disturbance of the body fluid-electrolyte balance (recent diarrhoea, or fever, or reduced water intake) can also lead to myokimia. The nerves can get hyperexcitable with caffeinated drinks, pre-workout stimulants, etc and can lead to myokimia. Most often, this twitch is self limiting, and resolves spontaneously without any treatment. 

 

Remedy for Eyelid Twitching

1) Good sleep for 7-8 hours is helpful. 

2) The muscles around the eyes can be relaxed by cold compression over the eyelids. 

3) Reduce eye strain by avoiding poor lighting, being in front of a computer screen for long hours, or watching the TV screen all day. 

4) Drinking good amount of water and keeping yourselves hydrated also helps.

 

Do I need to see an Eye Doctor? 

Even though twitching fades within a few days, in some cases it is necessary to see a doctor. Persistent twitch for more than a week needs medical attention. Twitching of not just the eyelid but other areas of the face (angle of mouth, or the neck) is an indicator of a neurological disease called facial spasm (hemi-facial spasm). Severe twitching that completely closes your eye is more likely to be neurological.

 

Facial Dystonias: A serious twitch

Normally, our facial muscles are under our voluntary control. We can smile when we want, and raise our eyebrow at our wish. In disorders such as facial spasms, this voluntary control is lost, and the nerves fire on their own: much like a short-circuiting wire that sparks spontaneously. This produces unwanted facial twitching and grimaces. Not only can these be socially bothersome, but when they are too close to the eyes, it can lead to functional blindness since the patient cannot keep the eyes open at their own will. Benign Essential Blepharospasm is one such disorder that affects both the eyes. Hemifacial spasm affects one half of the face.

These disorders generally have no permanent cure, or this option is too complex, such as a brain surgery, in case of Hemifacial spasm. 

Botulinum toxin causes relaxation of these overacting muscles, thereby allowing the patients to lead a normal life for a period of 3-4 months. It can then be repeated for continued effect. When Botulinum toxin is not effective (which may happen in a minority of patients), a surgical weakening of these muscles (myectomy) is required.

 Disclaimer: All views expressed here are based on my 20+ years of exclusive practice of eyelid and Oculoplastics. It does not represent the official views of my workplace, any medical society I represent, my country, or any ethnic group in particular. The information is meant for educational purpose only, and expert medical opinion is strongly recommended for your individual eyelid twitch. 

Dr. Milind Naik, MD                                

Oculoplastic Surgeon, Hyderabad 

Email: milind@drmilindnaik.com