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Should I Be Concerned When My Eyelid Twitches?

We all experience the occasional eyelid twitch, which is when the muscle of the eyelid spasms involuntarily. Usually, it comes and goes without intervention and while sure, it can be irritating, is a twitching eyelid ever something to be concerned about?

An eyelid twitch, also known as a myokymia, can affect the upper or lower lid and usually lasts for at least a few seconds and then may continue off and on for a few minutes. Usually unpredictable, twitching episodes can last several days and sometimes they may go away and then return weeks or months later. 

Causes of Eyelid Twitching

Although they may be bothersome, most eyelid twitches are nothing to cause concern and usually resolve on their own. However, in some rare cases, they may be a sign of a more serious problem, especially if they are accompanied by other symptoms – we will discuss this further below. 

Some known causes of eyelid twitches include:


  • Fatigue or lack of sleep
  • Stress
  • Eye irritation or dry eyes
  • Medications
  • Alcohol or caffeine
  • Physical exertion
  • Allergies
  • Eye strain (such as with extended digital device use)
  • Poor nutrition


Preventing and Treating Eyelid Twitching

Usually eyelid twitching will resolve itself within a couple of days or weeks but if it persists try to determine the cause in order to speed up the process. Consider going to bed a little earlier, cutting out caffeine or alcohol or finding ways to reduce or manage your stress. You can also try lubricating eye drops to add moisture to your eyes. If you take notice of when the spasms are happening and what else is going on in your life at that time (time of day, food intake, stress level, exhaustion) you can make some changes that will stop or prevent eye twitching from occuring. 

If you notice eye twitching in addition to vision disturbances or eye strain, contact your doctor for a vision assessment as it could be a sign of a refractive change. 

When is Eyelid Twitching a Concern?

If the eyelid spasms don’t pass and become chronic it may be a sign that you have a condition called benign essential blepharospasm. This condition is when the eye muscles blink uncontrollably and it usually affects both eyes. While the cause of blepharospasm is not known, it is more common in middle age women and there are a number of conditions that can exacerbate symptoms including: 

  • Eye inflammation (blepharitis) or infection (pink eye)
  • Dry eyes
  • Fatigue
  • Stress
  • Alcohol, caffeine or tobacco
  • Irritants or allergens in the environment

Blepharospasm is usually a progressive condition that can eventually lead to spasms in other muscles in the face, blurred vision and light sensitivity. The condition is sometimes treated with medication or Botox (botulinum toxin) to temporarily reduce the spasms and in severe cases, surgery may be performed to remove some of the muscles that are affected. 

On very rare occasions eye twitching can be a symptom of a more serious disorder affecting the brain or nervous system, however, usually it will be accompanied by other symptoms. Examples of such conditions include: glaucoma, hemifacial spasms, Parkinson’s disease, Bell’s palsy, multiple sclerosis, dystonia, and Tourette’s. A corneal scratch or abrasion can also be a cause of the eyelid muscle spasm. 

If you experience any of the following symptoms along with your eye twitching, see your doctor as soon as possible: 

  • Twitching that continues for more than a few weeks
  • Twitching that spreads to other areas of the face
  • A drooping upper eyelid
  • Red, irritated or swollen eyes 
  • Discharge coming from the eye
  • Spasms that cause the eyelid to close completely or difficulty opening the eyelid. 

In most cases, eye twitching is not something to worry about, but when you do experience a spasm it is worthwhile to take note of the circumstances so you know when your body is trying to tell you that something is out of balance. 

Signs of Eye and Vision Problems in Infants

Infant Eyesight

Despite nine months of growth in utero, babies are not born with fully developed eyes and vision – just like they can’t walk or talk yet. Over the first few months of life, their visual systems continue to progress, stimulated by their surroundings.

Babies will develop the ability to track objects, focus their eyes, and move them like a team. Their visual acuity will improve and they will gradually be able to see more colors. They will also form the neural connections that will allow them to process what they see, to understand and interact with the world around them. 

Healthy eyes and good vision are necessary for proper and timely progress; ocular or visual problems can lead to developmental delays. 

So how do you know if your infant is developing normally? What can you do to ensure your baby’s eye health and vision are on track? While infant eye problems are not common here are some steps you can take to ensure your child’s eyes are healthy. 

#1 Schedule a six month check-up.

It is recommended to get the first professional comprehensive eye and vision exam for your child between six and 12 months of age. 

Your optometrist should check for the following skills at the 6-month checkup:

  • Visual acuity (nearsightedness, farsightedness or astigmatism)
  • Eye muscle and movement capabilities
  • Eye health

If you have any concerns prior to six months, don’t hesitate to take your baby for an exam earlier. 

#2 Engage in visually stimulating play.

Incorporating visually stimulating play for your child will help develop visual processes like eye tracking and eye teaming. 

A baby’s initial focusing distance is 20-30 cm, so to nurture healthy vision skills, keep high contrast “reach and touch” toys within this distance. Alternate right and left sides with each feeding, and provide toys that encourage tracking of moving objects to foster eye-hand coordination and depth perception.

Pediatricians in North America recommend that NO screen time be allowed under the age of 2, as many forms of development may be delayed from premature use of digital devices. 

#3 Be alert to eye and vision problems.

Keep an eye out for indications of an eye health problem, and contact an eye doctor to discuss any concerns you may have. Some symptoms to pay attention to include:

  • Red eyes or eyelids, which may or may not be accompanied by discharge and crusty lids. This may indicate an eye infection that can be very contagious and may require medication. 
  • Excessive eye watering or tearing. This may be caused by a problem with the tear ducts, such as a blockage.
  • Extreme light sensitivity. While some light sensitivity is normal, significant sensitivity to light can be a sign of disease or elevated eye pressure. 
  • Eye “jiggling” or bouncing. This suggests a problem with the muscle control of the eyes.
  • Eye turn. Whether it is an eye that seems to cross in or a “lazy eye” that turns out, this is often associated with a refractive error or eye muscle issues that could require treatment such as eyeglasses, vision therapy, patching or surgery.
  • White pupil. This can be a sign of a number of diseases, including cancer. If you see this have it checked out immediately. 

Since your infant’s eyes are still maturing, any issues that are found can likely be corrected with proper care and treatment. The important thing is to find a pediatric eye care provider that you trust because you will want to regularly check the health of your child’s eyes to ensure proper learning and development throughout infancy and beyond.

AMD Awareness Could Save Your Vision

It’s that time of the year again. Each February, the optometric community bands together to create awareness about age-related macular degeneration (AMD). AMD is a leading cause of vision loss for people 50 years and older; early detection plays a key role in the outcome of the disease. That’s why bringing awareness to the disease and its risk factors is so important. 

Macular degeneration is a disease that damages the macula, which is a small area in the center of the retina responsible for sharp, clear central vision. The disease comes in two forms, wet AMD and dry AMD. The most common form, dry AMD, which affects around 80% of AMD patients, is when the macula gradually thins, and small clusters of protein called drusen begin to grow. Drusen result from cells in the macula that cannot rid themselves of metabolic waste called lipofuscin. The lipofuscin accumulates as drusen which causes a gradual vision decline. 

Dry AMD can turn into wet AMD when abnormal new blood vessels grow through breaks in a membrane layer of the thinning macula. The fragile blood vessels leak fluid into the macula, causing rapid decrease in central vision.The wet form is less common, yet it can cause a faster and more drastic vision loss. If a person has dry AMD which turns into wet AMD, this should be treated as soon as possible, as within days this can cause permanent scarring. Fortunately, there is effective treatment for wet AMD if detected before scarring arises. 

Both forms of AMD result in a loss of central vision, while peripheral vision stays intact. Symptoms can present as difficulty focusing on objects in front of you, or a blurred or dulled area in the central visual field which leads to having trouble reading, doing close work, driving or even recognizing faces. With time, the size of the blurred area can grow and eventually develop into black spots in central vision. Oftentimes patients don’t even notice symptoms until a significant amount of damage has been done. This is why regular eye exams are critical, especially if you are at risk. 

While AMD alone won’t cause complete blindness, it can cause a permanent, total loss of central vision if not treated. Vision loss can lead to a condition called low vision which can have a very serious impact on daily living and require a lot of assistance both by vision devices and the help of others. 

Are You at Risk? 

As it is an age-related disease, age is a significant risk factor for AMD, specifically once you reach 60. However, age is not the only risk factor. While some risk factors for AMD cannot be controlled there are lifestyle factors that you can change to prevent AMD.

Other than age, risk factors include:

  • Family history: If you have a family history of AMD, you are more at risk. Research has identified at least 20 genes that are associated with AMD, showing there is a genetic factor.
  • Race: Caucasian descent is a higher risk factor for AMD, and in fact, Caucasians with light irises have an increased risk from age 50.
  • Smoking: Smoking doubles your risk of developing AMD. 
  • Overweight/Obesity: Research shows that being overweight is a risk factor for AMD.
  • Having heart disease, high blood pressure and high cholesterol increase your risks.
  • Diet: An unhealthy diet rich in saturated fats is a significant risk factor.
  • Early exposure to UV light and blue hazard light (especially with the younger generation having increased exposure to digital devices) can cause early onset AMD. 

Here are some lifestyle steps you can take to reduce your risk of AMD:

  • Stop smoking
  • Eat a healthy diet rich in omega 3 fatty acids, (from fatty fish or flax seeds), leafy greens and colorful fruits and vegetables. 
  • Know your family history.
  • Exercise regularly.
  • Protect your eyes using UV protection and blue blocker coatings on eyeglasses.
  • Get regular eye exams.

In addition to a comprehensive eye exam, we are able to test for certain risk factors. For example, there is now technology available that can test for lutein levels via an in-house laboratory test – low lutein can indicate increased risk. In addition, genetic testing is also now available through a simple cheek swab to determine an individual’s risk for developing AMD. 


There is no known cure for AMD, however there are treatments available that may slow the progression of the disease. For dry AMD, studies have concluded that a particular high-dose combination of nutritional supplements taken daily can slow the disease. The combo includes vitamins C and E, Lutein, Zeaxanthin, Zinc and Copper. For wet AMD, the goal is to reduce the growth of abnormal blood vessels and the leakage that takes place and this is done through certain medications called anti-VEGFs which are injected into the eye or with laser surgery. 

Untreated macular degeneration can have devastating effects on your independence and quality of life. If you are 50 or over, speak to your Optometrist about your risk factors and what you can do to prevent AMD.