Eyelid twitching is common, usually harmless

But when might it call for a visit to your doctor?

Doctor, my eyelids have been twitching lately. What’s going on?

Small, uncontrolled eyelid twitches lasting just a few minutes are very common. The medical term for this is blepharospasm. For the most part, these involuntary eyelid twitches are harmless.

Sometimes the twitching can occur, off and on, over several days. Blepharospasm of this type may be associated with fatigue, stress, lack of sleep, excessive caffeine intake, physical exertion, or any combination of these. 

Sometimes, but rarely, the twitching can last weeks or even months. The muscle spasm is similar to the hiccups, but for the eyelids, not the diaphragm.

When your eyelid is twitching, it may look and feel like an earthquake to you, but it may not be noticeable to those around you. There are very rare medical conditions causing eyelid twitching that are associated with more widespread nerve or muscle diseases with other physical signs, including complete eyelid closure. In such cases it is important to see a doctor immediately.

It is important to note that 99 percent of eyelid twitching is completely harmless and will resolve on its own, especially by eliminating or reducing the associated factors such as fatigue, stress, lack of sleep, excessive caffeine intake, and physical exertion. In rare cases where the twitching can interfere with activities of living, medical interventions can be initiated.

For example, I had a patient who was a professional baseball player, and his eyes would twitch when he had the stress and squinting while batting. It was particularly troublesome to have fastballs coming in at 95 mph and to have his eyelids twitching while trying to either hit the ball or get out of the way if the pitch was coming in too close.

The condition had lasted several weeks and was very problematic. In his particular case, I injected a very tiny amount of medicine into the muscles of his eyelids to relax them, and the twitching went away.

Charles E. Crutchfield III, MD is a board certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He has been selected as one of the top 10 dermatologists in the U.S. by Black Enterprise magazine and one of the top 21 African American physicians in the U.S. by the Atlanta Post. Dr. Crutchfield is an active member of the Minnesota Association of Black Physicians, MABP.org.