Twitch Hunt

We all experience the lid twitch every now and then.  The upper or lower eyelid begins to intermittently spasm, and it seems the whole world can see it.  "I look like I have Tourette's," we think to ourselves.  In fact eyelid twitch, also known as eyelid myokymia, is almost imperceptible to others.  At least once a week, I see a handful of patients who rush in because their eyelids are doing the lambada.  If severe enough, eyelid myokymia may cause your world to seemingly bounce up and down as well (oscillopsia).

Why does this happen?  Essentially, the orbicularis muscle of the eye (in charge of opening and closing your eyelids) contracts rapidly in response to misbehaving nerves.  This usually occurs intermittently for a period of days, weeks, or even months.  Although extremely irritating, eyelid myokymia is benign (but if it lasts more than three months, call your eye doc).  It is triggered by such quotidian factors as inadequate sleep, fatigue, excessive caffeine, and emotional stress or anger.

Do you live in a large metropolitan area?  Do you down a grande latte mocaccino in your way to work?  Are you employed by the mafia or the CIA?  Or, are you leading a covert double-life and secretly hording a second family in Pennsylvania?  If you answered yes to any of the above, the lid twitch can happen to you at any moment.  Although there is no medicinal cure for it, eyelid myokymia improves with a good night's sleep, relaxation, and positive thinking.  Try to chillax with a glass of wine and a good Ingmar Bergman movie, or read the Seven Habits of Highly Effective People -- if nothing else it will help put you to sleep.


Walsh and Hoyt's clinical neuro-ophthalmology By Neil R. Miller, Frank Burton Walsh, William Fletcher Hoyt. 6th edition. Page 1216.