Why Your Eye Won't Stop Twitching

Ask-Hole is a regular series where our we answer questions about your life and gross body.

According to the modern age's Oracle of Delphi, WebMD, most people will develop an eye twitch at some point in their life. Eye twitches happen when the nerves surrounding the lid misfire. These twitches can range from a light fluttering of the eyelids to a full spasmodic wink accompanied by a jerking of the neck or shoulders. Some people with benign essential blepharospasm (that's fancy doctor talk for persistent eye twitching) report being unable to open their eyes for hours at a time. But most people's eye twitches aren't close to this severe. So what causes these twitches, exactly?

"I had [a twitch] for about three months when I was working on my dissertation," says Professor Nathalie Haurberg. "And then I finished grad school and it went away. So you know, maybe they can be cured by life accomplishments?" She's not far off. Accomplishments don't cure eye twitches, but stress is one of the main causes of them. According to Jodie*, a former ER nurse in the Pacific Northwest, eye twitches are usually caused by "lack of sleep and stress, particularly in conjunction." Jodie herself suffered from eye twitches during her last year of nursing school. "When I was finishing my masters and working 12-hour night shifts in the ER to pay for it, my left eye twitched incessantly for several months," she says.

"Usually, an eye twitch can be caused by too much caffeine from sources like coffee or soda," says Dr. Philip Rizzuto, spokesperson for the American Academy of Ophthalmology. "It's also caused by stress or lack of sleep. Those are the most common reasons if we're talking about an eye twitch on one side." It makes sense that caffeine and stress are the primary cause of eye twitches, as these things greatly affect our nervous system. The eye twitch is basically one symptom of a greater nervous system freak out.

An eye twitch can be a sign of something more serious. So how does one differentiate between the harmless eye twitches and the more serious ones? "My first move would be to ask them more about it," says Jodie. "When did it start happening? What seems to bring it on? Does anything make it stop? How long does it typically last? Are you having any other symptoms?" Other symptoms are a very important factor in diagnosing eye twitches, as blepharospasms accompany a host of other disorders. Things to consider for a differential diagnosis: do your eyelids droop (a symptom of Bell's palsy)? Do you have any other repetitive motions or tics (Tourette syndrome)? Has your vision changed in any way (scratched cornea)? Is your nose runny (histamines leaking into your eye goop)? Do your eyes hurt (glaucoma)? Does your neck twitch, too (cervical dystonia)? Are your fingers tingly (multiple sclerosis)? Questions like these will help separate serious cases from the infinitely more common diagnosis of being too stressed to be blessed with normal eyes.

"If you have a situation where a whole side of your face is twitching or pulsing, not just an eyelid," Rizzuto tells Broadly, "you should see a doctor right away. This is much less common but could be the sign of something more serious that may require treatment with drugs or surgery."

Eye twitches can also be a side effect of some medications. "I get them from a medication I'm prescribed to prevent migraines," says Abbey Friedman, who takes Cymbalta so her head doesn't explode from pain. Cymbalta is an antidepressant that also treats nerve pain. Friedman says she's mostly migraine free, "but since it's all neurological, it fucks with your muscles, hence the twitching." The twitches extend to other parts of her face. "My eyebrow actually twitches very subtly almost constantly," she says.

If your eye twitches are persistent enough, your doctor might recommend Botox. The drug was originally developed to treat nerve disorders; smooth, expressionless faces were just a side effect. "We might inject Botox near the affected area to temporarily provide relief," says Dr. Rizzuto. "But that isn't usually the first line of defense." The first line of defense is to reduce caffeine and increase sleep. Many people's eye twitches will go away on their own. Comedian Chris Clements had eyelid spasms for six months, "at least a couple times an hour if not more." Clements never went to the doctor, as he chalked it up to stress. "One day it was there, and one day it was gone," he says. "It was really maddening, though, while it was happening."

So don't worry, you're probably not showing the early signs of MS or an aneurism. "The signs of a rupturing brain aneurysm are not subtle like eye twitches," says Jodie. "I never saw a life-threatening condition that manifested itself as an eye twitch."

Not yet.

* Name has been changed