Eye Health

Blepharospasm (Eye Twitch) - Causes, Symptoms, Diagnoses and Treatments

Written by
Dr. Sneha Kannan
and medically reviewed by Dr. Manjunath Natarajan

Published on Sep 25, 2019 and last reviewed on Oct 03, 2019   -  4 min read



Blepharospasm is a rare eye condition that results in involuntary eyelid twitch. Read about its symptoms, causes, treatment, and ways to differentiate it from myokymia

Blepharospasm (Eye Twitch) - Causes, Symptoms, Diagnoses and Treatments

What Is Blepharospasm?

Blepharospasm, otherwise called benign essential blepharospasm, is a rare condition affecting the eyelids, which makes the eyelid blink or twitch involuntarily. It is a progressive neurological disorder. The muscle contractions cannot be controlled as it results due to muscle spasms around the eye. There are other minor causes that can make your eyes twitch like myokymia.

Points to Remember:

  • This condition rarely runs in families.

  • It is believed to originate in the motor nerves of the brain, but the exact cause is still not known.

  • It can be triggered by stress, fatigue, dry eyes, eye strain, and some medications.

What Causes Blepharospasm?

The cause of most cases of blepharospasm is not known, but there are many hypotheses that explain the possible causes. Some of the possible causes are:

  • Dry eyes and light sensitivity - Some patients have these symptoms before developing blepharospasm. But most patients did not have any eye problems previously.

  • Certain drugs - Medicines used to treat Parkinson’s disease and hormone replacement therapy can induce blepharospasm. It can also be a withdrawal symptom of benzodiazepines.

  • Abnormal functioning of the basal ganglia of the brain.

  • It is also associated with conditions like dystonia and multiple sclerosis.

  • It can also result from a concussion from a head injury.

  • Eye injury or trauma.

  • Environmental factors can trigger this condition.

What Are the Symptoms of Blepharospasm?

The signs and symptoms include:

  • Excessive blinking due to spasm of the eye muscles.

  • Sometimes, the twitches are so strong that it results in eyelid closure for minutes to hours.

  • Involuntary twitches or contractions of the muscles surrounding the eye.

  • Eye dryness.

  • Eye irritation.

  • Light sensitivity.

The symptoms become obvious when the person is tired or upset. Initially, the symptoms may be felt in one eye only, but as it progresses, both the eyes get involved. The symptoms appear only when the patient is awake, and a good night’s sleep helps delay the onset of symptoms the next day.

In advanced cases, the patient experiences severe spasms, making it difficult to open their eyes. Repeated attacks make the person functionally blind, as the patient cannot open the eyes and see even after having normal eyesight.

Most people suffering from blepharospasm also develop symptoms of dystonia in other parts of the body like neck, face, and mouth, eventually.

How Is Blepharospasm Diagnosed?

Blepharospasm is diagnosed clinically by a neurologist or ophthalmologist. There is no specific test to diagnose this condition, and diagnosis is made by ruling out all other causes of eye twitches. After a complete medical and physical examination, the doctor will rule out the following conditions before diagnosing the condition:

  • Myokymia.

  • Eye problems.

  • Meige syndrome.

  • Parkinson’s disease.

  • Tourette’s syndrome.

  • Hemifacial spasm.

  • Focal seizures.

  • Brain injury or tumor.

How Is Blepharospasm Treated?

There is no cure for this condition, but treatment can reduce the symptoms. The treatment options include:

  • Medicines - Anticholinergics, tranquilizers, and botulinum toxin are used. But, it results in a lot of side effects and is not prescribed commonly. Nowadays, Mosapride is being used in the treatment, which is a safer and economical option.

  • Botox injection - Injecting Botulinum toxin is the preferred treatment option, as it induces localized paralysis. This injection is administered every 3 months. Most patients respond well to Botox injection and lead an almost normal life. For some, the effectiveness reduces after years of use.

  • Surgery - If the symptoms are not relieved with the help of medicines or botox, then surgery is done. During surgery, the muscles responsible for closing the eyelid (protractor myectomy) are removed.

  • Sensorimotor retraining - Series of sensorimotor training techniques include exercises to improve neuroplasticity, which will help the brain heal itself and eliminate dystonic movements.

  • Sensory trick - A new device is used to apply pressure to the temple region, which helps patients open their eyes.

What Are the Home Remedies for Blepharospasm?

You can manage the symptoms by:

  • Wearing protective sunglasses.

  • Using lubricating eye drops.

  • Applying hot or cold compression to the eyes and surrounding areas.

  • Keep using the facial muscles to whistle, sing, and talk.

What Are the Other Common Causes of Eyelid Twitches?

Eyelid twitches can be due to:

  • Eye strain.

  • Eye irritation.

  • Sleep problems.

  • Tiredness.

  • Too much stress.

  • Exertion.

  • Side effects of some medicine.

  • Alcohol or tobacco use.

What Are the Other Serious Conditions That Can Cause Eyelid Twitches?

Everybody experiences eye twitching at some point. But rarely, it can be due to severe underlying condition like:

  • Bell’s palsy or facial palsy - results in one-sided paralysis of the face.

  • Dystonia - results in unexpected and involuntary muscle spasms anywhere in the body.

  • Multiple sclerosis (MS) - it is a disorder that causes cognitive and movement problems and muscle weakness.

  • Parkinson’s disease - results in involuntary tremors in the limbs, muscle stiffness, and balance problems.

  • Tourette syndrome - results in involuntary movement and verbal tics.

Blepharospasm is commonly seen in middle-aged women. The exact cause is not known, but genetic, environmental, and other factors seem to play a role. There is no cure for this disease as of now, but to know more ways to relieve symptoms, consult a doctor online.

Last reviewed at:
03 Oct 2019  -  4 min read


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