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Eyes Twitches? Your Lids May Just Need Some Shut Eye.

  • Published16 May 2022
  • Author Daphne Yao
  • Source BrainFacts/SfN
Woman with hand on eyes holding glasses
iStock.com via tommaso79

Whether it was from staring at your computer screen for too long, mounting stress, or lack of sleep, your eyelid began to twitch. Eye twitches, known as myokymia, are so common that some cultures even assign good or bad luck to twitches on different eyelids. But we rarely think about what’s happening in our bodies leading to them.

BrainFacts.org talks with neuro-ophthalmologist Rudrani Banik about the causes and solutions to an eye twitch.

What are the most common causes of eye twitching?

A lot of lifestyle habits and choices can be associated with eye twitching. The most common one is stress, but there’s also lack of sleep or excessive caffeine use. I’ve even seen in some of my patients that dehydration can cause eye twitching.

Does excessive screen time affect eye twitches?

Spending a lot of time on your screen can definitely result in eyelid twitching. Normally, we blink 15 times a minute, but when we’re focused on a screen or have been reading for a long time, we only blink four or five times a minute. When we don’t blink enough, the surface of our eyes gets dry, and that causes eye twitches.

What’s happening to your eyelid when it twitches?

Usually, it’s a small group of fibers that leads to the twitching, taking the signal from a single motor neuron group. Contractions of a few fibers of the eyelid muscle — not the entire eyelid — correspond to the twitch you experience.

What’s happening in your brain to cause the eye twitch?

Explore the Cranial Nerve VII root, Facial 3D BRAIN

The nerve that’s responsible for eyelid twitching is the seventh cranial nerve, the facial nerve. The nerve sits within the brainstem in the pons. When there’s irritation along that nerve, such as a small nerve segment demyelinating (as in the case of multiple sclerosis or vitamin B12 deficiencies), it could trigger the muscle responsible for closing the eyelid. The eyelid then starts to twitch.

With excessive screen time and dry eye, scientists hypothesize that the fifth cranial nerve comes into play as well. The cornea is densely innervated, and the fifth cranial nerve — involved in relaying sensation from the eyes — is also housed in the pons, close to the seventh nerve. Dry eye will trigger the 5th (trigeminal) nerve which in turn may activate the seventh (facial) nerve to trigger blinking.

Could eyelid twitches ever be harmful?

The good news is that eyelid twitches, what we call eyelid myokymia, are self-limited: they usually go away on their own. If only one part of your eyelid is twitching, it’s most likely benign. If it doesn’t go away and involves more muscle groups in the face, that’s quite different from pure eyelid twitching and signals underlying causes that are more serious. If you’re exhibiting these symptoms, I would recommend a check-up by an ophthalmologist or neuro-ophthalmologist, just to make sure there’s nothing pushing on or causing inflammation of your facial nerve.

How do we control or stop eye twitches?

Resting your eyes helps a lot. The American Academy of Ophthalmology recommends the 20-20-20 rule. After 20 minutes on your screen, rest your eyes for 20 seconds by looking at something 20 feet away. I have a twist on the rule, which I call 20-20. After 20 minutes of eye use, simply close your eyes for 20 seconds. This helps lubricate your eyes.

Looking at your habits and adjusting them also helps. Depending on your current lifestyle, you could try reducing caffeine intake or incorporating stress reduction strategies like meditation.

Baudouin C, Aragona P, Messmer EM, Tomlinson A, Calonge M, Boboridis KG, Akova YA, Geerling G, Labetoulle M, Rolando M. Role of hyperosmolarity in the pathogenesis and management of dry eye disease: proceedings of the OCEAN group meeting. Ocul Surf. 2013 Oct;11(4):246-58. doi: 10.1016/j.jtos.2013.07.003. Epub 2013 Aug 9. PMID: 24112228.]

Banik, Rudrani MD; Miller, Neil R. MD Chronic Myokymia Limited to the Eyelid Is a Benign Condition, Journal of Neuro-Ophthalmology: December 2004 - Volume 24 - Issue 4 - p 290-292 

Jafer Chardoub AA, Patel BC. Eyelid Myokymia. [Updated 2021 Nov 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560595/  

 
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