How bad is a twitching eyelid? That depends on who you listen to. In epic Sanskrit poem the Ramayana, a pulsating eye can be a good or bad omen depending on which eye it is and who it belongs to – while in some Trinidadian traditions, it might portend a visit from a friend or a loved one in trouble. More recently, it’s become common visual shorthand for an over-caffeinated – or extremely stressed – cartoon character.
But what if it happens to you? Well, the good news is, if it’s infrequent, you almost certainly don’t have anything to be concerned about. “There are several reasons why a twitch in the eyelid can happen,” says Dr Cornelius Rene, a consultant oculoplastic surgeon at Addenbrooke’s Hospital in Cambridge. “But the commonest cause is something called benign essential blepharospasm, or BEB, which is an uncontrollable spasm of the eyelid, for which there is often no underlying cause. If it’s just one eyelid twitching, then that is usually what we call myokymia, which is a pretty benign condition that is usually transient and typically gets better on its own.”
For some people, BEB can be difficult to avoid – recent studies suggest that 20-30% of sufferers have a family history of the condition. But there might be other risk factors: 2022 research indicated that living in an urban environment or working in a “white collar” job associated with a stressful lifestyle can have an effect, while spending a long time watching TV or working at a computer is also associated with the problem.
“Myokymia will usually resolve itself over a short space of time,” says Dr Rene. “If you’d like to minimise your chances of suffering in the first place, you can cut down on the amount of coffee you’re drinking or try to reduce your stress, but it will typically go away in minutes, hours or days anyway.”
What if it doesn’t? “If you experience a persistent twitch that lingers for more than two weeks and notice any unusual changes in your eye’s appearance or sensation, it may be indicative of an underlying issue,” says Dr Luke Powles, associate clinical director at Bupa Health Clinics. “These might be early indicators of multiple sclerosis or Parkinson’s disease, a progressive brain disorder that can lead to muscle stiffness and tension, making movements and facial expressions more challenging.”
This means that it is worth having any issues checked out early – but frequent twitching or blinking can itself become a problem if it progresses to the point where it interferes with everyday life, a more severe version of blepharospasm. For advanced cases, opthalmologists might consider using botulinum toxin injections, such as Botox, to weaken the muscles undergoing spasm, or even surgery on the orbicularis muscle that causes closure of the eyelid.
For the occasional twitch, though, none of this is likely to be necessary. As with many eye-related issues, most people will benefit from taking a few simple steps to improve their overall ocular health, since dryness around the eyes can make spasms more uncomfortable in the short term.
If you’re looking at a screen a lot, remember the 20-20-20 rule: take a break of at least 20 seconds, every 20 minutes, to look at least 20ft away. And, even if it sounds obvious, remember to blink. “It’s easy to forget when you’re looking at a screen,” says Dr Rene. “But regular blinking can refresh your eyes.”
One option is to form an if-then habit – for instance, reminding yourself to purposefully blink every time you refresh your social media account or check your email. Finally, tiredness is a factor – so if you are reading this late at night on your computer, take a good, long blink, and then go to bed. A twitch might not be a good omen, but everything’s easier to face after a decent night’s sleep.
