There it goes again. Most of us, at one time or another, have experienced eyelid twitches (also known as myokymia): mild, involuntary contractions of the orbicularis oculi muscle, located under the skin around the eyelid. Usually occurring on one side and in the lower lid, twitching tends to be short-lived, lasting a few seconds or minutes, but can recur over a few hours, days or longer.
Though these twitches can be annoying, for sure, they are usually nothing to worry about, says Eleanore T. Kim, M.D., a New York City-based ophthalmologist affiliated with NYU Langone Health: “Eyelid twitching is quite common, usually harmless, and usually goes away on its own.”
Stress, fatigue, caffeine and alcohol. “One thing I ask patients who complain of twitching is, ‘How much caffeine do you drink a day?’” Kim says. Indeed, downing a lot of caffeinated beverages (such as coffee, tea, soft drinks and energy drinks) can cause quivering. She notes that caffeine increases sympathetic nerve activity, which may lead to more stimulation of the eye muscle.
A few small lifestyle tweaks may prevent bothersome twitches — for example, getting enough shut-eye (aim for seven to eight hours a night), carving out some time to de-stress during the day (say, 10 minutes of deep breathing or a walk around the neighborhood), and cutting back on the amount of soft drinks, java or vino you consume.
Dry eye and inflammation. Twitching may accompany an irritating eye condition. Dry eye — particularly common these days, with so many of us working from home and spending a lot of time in front of a computer — is often associated with eyelid twitching. Those masks we’re wearing for protection during the COVID crisis can make things worse. If the mask you’re wearing doesn’t fit securely, the air you exhale can flow up and hit the surface of the eyes, which can dry out the tear film on the surface, thus exacerbating dry eye, says Andrew Iwach, M.D., the executive director of the Glaucoma Center of San Francisco.
An inflammation of the eyelid known as blepharitis, usually caused when tiny oil glands near the base of the lashes become clogged, can also cause twitching. “As we get older, the oil [produced in the glands] can get a little thicker and accumulate a bit on the lid margin,” Iwach says. That excess oil can also invite excessive bacterial growth and lead to infection.
If eyes feel dry, restore moisture by lubricating the surface of the eyes with artificial tears. Cleaning the lids each night, before bed, can prevent the oil glands from getting clogged. Iwach suggests using warm water and mild soap or baby shampoo or buying packaged pads infused with a gentle cleaning solution. A warm compress, placed over closed lids, can also help loosen excess oil. “If there’s an underlying infection, we may put patients on antibiotics,” Iwach says. You might also consider investing in a humidifier to add more moisture to the air inside your house during the dry winter months ahead.