Eyelid spasms and twitching can be an annoying issue. They can be the result of everyday problems such as stress, or they can be indicators of larger problems. If you would like to discover what’s causing your eyelid spasms and what to do about them, please contact Dr. Sean Paul to find out more. 

What are eyelid spasms?

An eyelid spasm, or blepharospasm, is a commonly experienced symptom characterized as a sudden, involuntary twitching of the eyelid muscles, generally around one eye. Eye twitching and eyelid spasms are repetitive, uncontrollable blinking and/or spasms of the eyelid, usually affecting the upper lids. Benign essential blepharospasm often affects the eye muscles of both eyes. The most common types of eyelid spasms are: 

  • Eyelid twitch (or myokymia)
  • Benign essential blepharospasm
  • Hemifacial spasm 

About eyelid spasms

Most people develop a minor eyelid twitch or benign essential blepharospasm at some point in their lives, although the cause is generally unknown. The most common factors that make the muscle in the eyelid twitch are fatigue, stress, and caffeine. Once spasms begin, they may continue off and on for a few days, but typically do not occur during sleep. 

Most people have this type of eyelid spasm once in a while and find it very annoying. It is painless and harmless and usually goes away on its own; however, this issue can be quite frustrating. This is especially true if the spasms are strong enough to cause the eyelids to completely shut and then re-open.

When do eyelid spasms require treatment?

In some cases, eye spasms are more than a temporary nuisance. For some people, they occur frequently throughout the day. Symptoms can recur for days, weeks, or even months. This can cause a lot of emotional distress and interfere with quality of life. In its most serious forms, eyelid spasms can become chronic, causing persistent winking and squinting. If it progresses to the point where it’s difficult to keep your eyes open, these spasms can cause severe vision impairment. In this case, a number of our patients have found relief with Botox injections repeated on average every three months.

Severe eyelid spasm disorders

Benign essential blepharospasm and hemifacial spasm are uncommon, chronic, and disabling medical conditions. Both disorders result in constant and uncontrollable blinking, which interferes with the performance and enjoyment of many day-to-day activities and may even render a patient functionally blind and occupationally handicapped. If you are unsure whether you have one of these conditions, a diagnosis can be made by Dr. Paul. He will examine you and observe your facial movements to determine your condition. 

Chronic eye spasms can be a symptom of:

  • Inflammation of the eyelids (blepharitis)
  • Dry eyes
  • Pink eye
  • Sensitivity to light

Undiagnosed corneal scratches can also cause chronic eyelid twitches. If you think you have an eye injury, make an appointment with Dr. Paul immediately, as corneal scratches can sometimes cause permanent eye damage.

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Hemifacial spasm

Hemifacial spasm is quite rare, and involves more than just the eyelid muscles. It also usually involves the muscles around the mouth. Unlike other types of eyelid twitching, hemifacial spasm usually affects only one side of the face. In most cases, it is caused by an artery pressing on the nerve to the facial muscles. 

The initial symptoms may be twitching of the eyelids, with progression involving the muscles on one entire side of the face. The severity of symptoms vary from mild fluttering to forceful contraction. Unlike blepharospasm, this condition can occur during sleep. Less than 1% of cases are caused by a tumor, in which case Dr. Paul may recommend magnetic resonance imaging (MRI).

What else could be causing eye spasms?

Eyelid spasms can also be a symptom of a more serious brain or nerve disorder. When the eyelid twitches are a result of these more serious conditions, they are almost always accompanied by other symptoms. If Dr. Paul suspects that a brain or nerve disorder is responsible for eye twitching, he will examine you for other common signs. Brain and nerve disorders that may cause eyelid twitches include:

Bell’s palsy (facial palsy)

Bell’s palsy causes one side of your face to droop downward


Causes unexpected muscle spasms and the affected area’s body part to twist or contort

Multiple sclerosis (MS)

A disease of the central nervous system that causes cognitive and movement problems, as well as fatigue

Parkinson’s disease

Causes trembling limbs, muscle stiffness, balance problems, and difficulty speaking

Tourette’s syndrome

Characterized by involuntary movement and verbal tics

Is my eye spasm an emergency?

Researchers believe that eye twitching may result from a combination of environmental and genetic factors. Although the condition is usually random, it sometimes runs in families. Eyelid twitches are rarely serious enough to require emergency medical treatment; however, chronic eyelid spasms may be a symptom of a more serious brain or nervous system disorder as noted above.

You should make an appointment to see Dr. Paul if you’re having chronic eyelid spasms and any of the following also happens:

  • Your eye is red, swollen, or has an unusual discharge
  • Your upper eyelid is drooping
  • Your eyelid completely closes each time your eyelids twitch
  • The twitching continues for several weeks
  • The twitching begins affecting other parts of your face

What is the best treatment for eyelid spasms?

Most eyelid spasms go away without treatment in a few days or weeks. If they don’t, you can try to eliminate or decrease potential causes. The most common causes of eyelid twitch are stress, fatigue, and caffeine. To ease eye twitching, you might want to try the following:

  • Drink less caffeine
  • Get adequate sleep
  • Apply a warm compress to your eyes when a spasm begins
  • Keep your eye surfaces and membranes lubricated with over-the-counter artificial tears or eye drops

Botox for eyelid spasms

Dr. Paul may sometimes recommend Botox® to treat chronic headaches, which can cause eye twitching. Botox is regarded as the most effective treatment of choice for the rapid but temporary treatment of blepharospasm. More than 95% of patients with symptoms report significant improvement with use of Botox. It works by causing temporary paralysis of the associated muscles, with a peak of effect at five to seven days after injection. 

Patients typically note the onset of relief three days after injection, with a duration of relief from symptoms of three months. More than 5% of treated patients have sustained relief for more than six months, although some patients require injections as often as monthly. Botox has proven to be an excellent treatment for some patients suffering from eyelid spasms.

Providers who perform Eyelid Spasms (Blepharospasm) treatment at Austin Face & Body

Dr. Sean Paul

Dr. Sean Paul is the founder of Austin Face & Body. As a widely published surgeon who has traveled all over the world to speak, Dr. Paul is renowned and highly regarded in his industry. He specializes in cosmetic and reconstructive eyelid and facial plastic surgery in Austin, and is board certified by the American Board of Ophthalmology.

Dr. Sean Paul »

Dr. David Gay

A passionate and highly regarded board certified surgeon who is known for incredible results, wonderful bedside manner, and selfless humanitarian work, Dr. David Gay represents everything the medical profession should be.

Dr. David Gay »

Schedule a consultation with us

If eyelid spasms are bothering you and you would like to learn more, please schedule a consultation with us. Dr. Sean Paul is a gifted ophthalmologist in Austin who has the ability to correct problems of the eyelids and improve his patients’ quality of life. For more information, or to schedule a consultation, please call 512-559-3544 or contact us online.

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