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  • What Is an Eyelid Spasm or Twitching Eyelid?

    Published Apr. 27, 2023

    What are eyelid spasms?

    Eyelid spasms are when one or both of your eyelids twitch or suddenly close. These movements are involuntary, meaning that they are out of your control.

    The most common types of eyelid spasms are: eyelid twitch (or tic), essential blepharospasm, and hemifacial spasm.

    What is an eyelid twitch?

    An eyelid twitch (or tic) is when your eyelid quickly moves a little. This movement does not affect your vision. Eyelid twitches are common, and often caused by stress and being tired.

    Most eyelid twitches are minor and go away without treatment. You can often get rid of eyelid twitching by getting enough sleep, reducing stress, and limiting your caffeine.

    If your twitches seem to be getting worse, be sure to tell your ophthalmologist.

    What is essential blepharospasm?

    Essential blepharospasm is when one or both of your eyelids close involuntarily. This can last for a few seconds to a few hours. When it first starts, you might blink, wink, or pinch up your face. In advanced stages, your eyelids may shut so tightly you cannot see. These spasms can also affect other muscles in your face. It may be hard to climb stairs, drive a car, go to work, or do other things.

    Doctors know blepharospasm is caused by a nerve impulse, but they are not sure why it happens.

    What is a hemifacial spasm?

    Hemifacial spasm is when muscles on one side of your face constrict (tighten up). These spasms may start near your eye and then affect other parts of your face. In advanced cases, a hemifacial spasm can last for several days to a few months.

    Hemifacial spasms seem to happen when a blood vessel presses on a facial nerve.

    To be sure you have one, more testing like an MRI (magnetic resonance imaging) may be needed.

    How is blepharospasm treated?

    There are a few options for treating blepharospasm. The most effective treatment is botulinum toxin injections (shots), a muscle-relaxing substance. A very slender needle is used to inject the medicine into muscles above and below your eye. Spasms begin to disappear anywhere from a day to 2 weeks after the injection. This relief lasts about 3 months.

    If injections are not helpful or recommended, some medications may help for blepharospasms. Your ophthalmologist will work to find the right mix of medicines to help. It is a matter of finding the right balance between benefits (how medicine helps) and side effects (problems that medicine can cause).

    Surgery is an option when injections and medicine do not work. There are two common types of surgery for essential blepharospasm. One type removes the facial muscle that is causing spasms. Another type removes a portion of the nerve to make spasms less severe.

    Your ophthalmologist will discuss treatment options for your case of blepharospasm.

    How is a hemifacial spasm treated?

    Most people with hemifacial spasms find treatment with botulinum toxin injections to work well. As with blepharospasm treatment, these injections are used to relax the nerve in hemifacial spasms.

    Occasionally, drug treatments are used, but they are generally less effective than injections. Rarely, surgery is used to relieve pressure on the nerve.

    Your ophthalmologist will discuss which type of treatment is right for you.