Eyelid Myokymia (Lid Twitching)

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It happens to many of us – out of the blue, your eyelid starts twitching uncontrollably, and you’re sure everyone around you can see it.  Fortunately, in the majority of cases it is an occurrence that is bothersome at most. 

Myokymia is a general term used to describe a quivering or involuntary movement of a single muscle or muscle group around the eye.  It is caused by a misfiring of the neurons supplying the eyelid muscles.  The most commonly affected muscle is the orbicularis oculi muscle that closes the lids over the eye.  This results in subtle twitching of the upper and/or lower eyelid.  Less commonly, the superior oblique muscle, which moves the eye down and toward the nose, may be involved.  In this case, a person may suffer from double vision or oscillopsia (a visual sensation that stationary objects are moving) during an episode.

While an eyelid myokymia feels incredibly noticeable to the sufferer, it is barely perceptible to any observer.  This condition usually occurs in young, healthy individuals and tends to present intermittently at different times throughout the day.  Frequent contributing factors include too much caffeine, high levels of anxiety, fatigue, stress, overwork, and a lack of sleep. Usage of certain drugs and alcohol may also be involved.  .  Eye irritation or a foreign body in the eye can also be triggers – these should be assessed for by your eye care practitioner.  

Eyelid myokymia most often resolves spontaneously, but it can persist for weeks to months in some cases.  Cold compresses over the eyes may help suppress the twitching, but the most beneficial treatment is to relieve the contributing factors.  Reducing caffeine and alcohol intake, getting more sleep and stress management will typically allow resolution of the condition.  Although there are no clinical studies, there is anecdotal evidence that topical or oral antihistamines can be helpful.  For more severe or prolonged courses of eyelid myokymia, Botox injection may be considered.  

In rare situations, this condition can occur as a precursor to blepharospasm, a more severe form of myokymia, or hemifacial spasm.  If the myokymia persists or involves other facial muscles besides the eyelids you should see your optometrist or family physician for further assessment.

Written by Trevor Miranda

Dr. Miranda was raised in Simcoe, Ontario and graduated from the University of Waterloo with his Doctorate of Optometry in 1995. Following graduation, he moved to beautiful Vancouver Island, where he continues to serve the eye care needs of the Cowichan Valley. Trevor is also an active member of the Third World Eye Care Society and has participated with other professionals to improve the vision of the less fortunate. Dr. Miranda was named Optometrist of the Year by the British Columbia Association of Optometrists in March 2015. This prestigious honour recognized Dr. Miranda’s commitment to providing every patient with exceptional care while mentoring optometrists across Canada. Outside the office, you will find Trevor enjoying hockey, coaching soccer, involved with the South Cowichan Rotary Club, and spending time with his wife Cheryl and their three children. Trevor looks forward to continuing to care for the eyes of the Cowichan Valley and welcomes new patients without a referral. Dr. Miranda is available for appointments in our Duncan and Cobble Hill.
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