Eyelid spasms

What are eyelid spasms?

Eyelid spasms are little muscle spasms in the muscles of the upper or lower eyelid. Most eye twiches are harmless, involuntary spasms of the muscles surrounding the eye. They causes mini twitches that are clearly felt by the person having them. They can often be observed by others as well. They can be quite disturbing; luckily most only last for a short period of time, for no more than a few hours; and they can come and go sporadically.

In more extreme and serious cases, they can last for weeks or months. If you are experiecing deep spasms in the eyelids and/or around the face, you should contanct a doctor immediately. This could be a sign of a more serious under-lying condition.

Causes of eyelid spasms

Common causes of eyelid twitching are:

• short-term stress
• eye strain, such as from lots of computer use or hours of small focused hand work (such as threading a needle over and over), and from straining the eyes when reading a book without proper light or magnification.
• squinting a lot, such as from the sun, reading or other things. (The muscles essentially tire out.)
• Consuming too much caffeine
• exhaustion; lack of sleep
• anxiety or temporary panic fits and nervousness which can be easily relieved and recover naturally by rest and relaxation.

Causes of more severe forms of eyelid spasms are mentioned below.

Types of eyelid spasms

Eyelid Twitch
This is the most common and minor form of eyelid spasms. The cause of minor eyelid twitching is most likely caused by some of the sources listed above. A slight spasm of the lower eyelid or even both eyelids is common and harmless. These generally can be treated like any other muscle spasm in the body: the muscles should be rested and relaxed.

Essential Blepharospasm
This is a more extreme form of eyelid spasms. Essential Blepharospasm is an involuntary condition that involves (generally) both eyes, where the eyelids, and sometimes the eyebrows, close involuntarily. In advanced cases the muscles of the mouth or neck might be affected. During spasm, one's vision may be temporarily impaired due to involuntary closing of the eyelid. While these spasms are rare, they can be quite challenging. Blepharospasm is caused by abnormal nerve impulses that produce muscle spasms. Blepharospasm behaves in the body similarly to familial tremor.

Hemifacial Spasm
Hemifacial spasm is also a more serious form of eyelid spasm. It is a condition that involves the eyelid muscles and the muscles around the mouth, but on only one side of the face. Hemifacial spasm is usually caused by an artery pressing on the nerve to the facial muscles causing the face to twitch.

Treatment

Eyelid twitch

Minor eyelid twitches require no treatment as they usually resolve on their own. Eliminating the cause of stress will correct the problem; in the meantime, some notice relief from warm and/or cold soaks and rinsing the eye out with warm (not hot!) water.

Some ophthalmologists recommend reducing the intake of caffeine and/or sugar substitutes such as aspartame (including NutraSweet).

Blepharospasm

This type of eyelid spasm will require more extreme treatment. Mild cases can be treated with biofeedback and certain medications. However, more extreme cases will require an injection of botulinum orsurgery. Surprisingly, Botulinum injections are one of the most common treatments used for blepharospasm. This is the same injectable treatment, called Botox that people use to minimize wrinkles on the face. Botulinum helps to relax/paralyze the facial muscles when injected. It injection last for a several months; once it wears off the treatment needs to be repeated. Generally, this treatment has few side-effects. However, some temporary side-effects can include: droopy eyelids, double vision, or dry eyes. In the most extreme cases, opthamologists may perform surgery to remove the nerve that is causing the spasm.

Hemifacial spasm

Similar to blepharospasm spasm, Botulinum injections can be beneficial in relieving the eyelid spasms in patients with hemifacial spasm. However, this type of spasm may require surgery. Surgery would a neurosurgical procedure that would relieve the pressure of the artery on the nerve. As with any surgery, there is risk of more serious complications.

References

• Ophthalmology Clinic at the Kellogg Eye Center