What makes your eye twitch?
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Blapharospasm is another name for involuntary eye twitching. Eye twitching occurs when there are involuntary muscle contractions happening around the eye area. Twitching may occur under the eye, on the lid of the eye, etc.
Benign Essential Blapharospasm (BEB) is one type of blinking disorder that is not dangerous. It is also the most common and the cause of this disorder is unknown.
Blapharospasm usually begins with abnormal and excessive eye blinking along with eye irritation. Certain triggers may make it worse such as light, stress, or fatigue. The spasms may continually get worse. Sometimes the spasms become so strong that the eye remains shut for several hours.
If eye twitching does not go away or becomes worse it is important to see a doctor right away.
Part II of III
If it is the eyelid that is doing all the twitching, the condition is usually caused by a spasm. The three most common types of eyelid spasms are eyelid twitch, essential blepharospasm, and hemifacial spasm. Eyelid Twitch: the cause of minor eyelid twitching is unknown. A slight spasm of the lower eyelid or even both eyelids is common and of no concern. Essential Blepharospasm: this is an an involuntary condition usually involving both eyes, where the eyelids, and sometimes the eyebrows, close involuntarily. In advanced cases of essential blepharospasm, muscles of the mouth or neck are sometimes involved in these spasms. When these spasms occur, temporary inability to see may result because of the involuntary eyelid closure. These spasms are rare but very troublesome, and often incapacitating. Blepharospasm is caused by abnormal nerve impulses producing muscle spasms, and almost never a psychiatric disease. Hemifacial Spasm: this is a condition which involves the eyelid muscles and usually the muscles around the mouth, but on only one side of the face. Hemifacial spasm is usually caused by an artery pressing on the nerve to the facial muscles causing the face to twitch. The most common symptoms are twitching or spasm around the eyes and facial spasms. However, these symptoms do not necessarily mean that you have eyelid spasms. Consult your physician if you have been experiencing any of these symptoms and he/she will be able to instruct you on the course of treatment.
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Since eyelid twitching is more common than nystagmus, I have included common treatments for the condition.
Eyelid Twitch: Minor eyelid twitches require no treatment as they usually resolve spontaneously. Reducing stress, using warm soaks, or correction of any refractive error may help. Some ophthalmologists recommend reducing caffeine usage.
Blepharospasm: Can be treated with medications, biofeedback, injection of botulinum and surgery. Medications and biofeedback are rarely successful in managing blepharospasm, but may be advised in mild cases or cases not responding to other treatment. Botulinum injections are now the most commonly recommended treatment for blepharospasm. Injection of botulinum (botulism toxin) in very small quantities into the muscles around the eyes will relax the spasm. The injection works for several months, but will slowly wear off and usually needs to be repeated. The treatment is very successful with few side-effects. On those rare occasions when side-effects do occur, they include drooping of the eyelids, double vision or dryness of the eye, but they all subside as the injection wears off. Your ophthalmologist may suggest surgery to remove either the nerve causing the spasm or the spastic muscles themselves. The surgical results are generally permanent and any side-effects are also usually permanent.
Hemifacial Spasm: Botulinum injections may be beneficial in relieving the eyelid spasms in patients with hemifacial spasm. A neurosurgical procedure for hemifacial spasm may relieve the pressure of the artery on the nerve. While it is generally successful, it is a major neurosurgical operation and serious complications are possible.
An eye twitch, or blepharospasm, can be caused by a variety of reasons. Stress, fatigue or caffine intake are the three most common however an injury to your cornea or a case of pink eye can also be the culprit.
Part I of III.
I think it would be helpful to first specifically define what kind of eye twitch you are referring to. Does the actual eyeball twitch or just the eyelid? If it is the eyeball, does it twitch from side to side or does it feel as if it twitches towards the front and rear of the eye socket? Twitching of this sort is often referred to as nystagmus. Nystagmus is the rhythmical oscillation of the eyes, occurring from vestibular and optokinetic stimulation (or pathologically in a wide variety of diseases). There are a few different types of nystagmus: Jerk Nystagmus: this a slow drift off the target, followed by a fast corrective saccade. Many people are oblivious to this type of nystagmus. Others complain of blurred vision or a to-and-fro movement of the environment. Gaze-evoked nystagmus: this is the most common form of jerk nystagmus. This can be triggered by drugs (sedatives, anticonvulsants, and alcohol); muscle paresis; myasthenia gravis; demylinating disease; brain lesions. Vestibular nystagmus is pretty severe. Often, it is accompanied by vertigo and sudden shifts of the head. Downbeat nystagmus is pretty rare, and is usually associated with stroke or CNS tumor.
Braunwald, E, Fauci, A, Kasper, D, Hauser, S, & Longo, D. (2001). Principles of internal medicine. Boston: McGraw-Hill.
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