It happens to all of us - out of the blue, your eyelid starts twitching uncontrollably, and you're sure everyone around you can see it. You shouldn't worry, though, because in the majority of cases it is an occurrence that is bothersome at most.

Myokymia is a general term used to describe a quivering or involuntary movement of a single muscle or muscle group around the eye. It is caused by misfiring of the nerves communicating with the eyelid muscles. The most commonly affected muscles are those that close the lids over the eye (called orbicularis), and the superior oblique muscle, which moves the eye down and toward the nose. In the latter case, patients may see double during an attack; in the former, and more common scenario, it is usually a simple twitching in the upper or lower lid. While it feels incredibly noticeable to the sufferer, it is barely perceptible to any observer. This condition can resolve spontaneously, but it can also last up to three weeks and be very annoying.

Frequent contributing factors include too much caffeine, high levels of anxiety, fatigue, stress, overwork, lack of sleep, and nutritional imbalances. Some reports have indicated a lack of potassium or magnesium. In addition, alcohol consumption may cause lid twitching. This condition usually occurs in young, healthy individuals and should be assessed by an eye care practitioner.

To help suppress the twitching, there are several simple treatment options: cold compresses over the eyes, sleep, oral antihistamines, potassium supplements (eat more bananas) and Vitamin B-12 supplements. A multi-vitamin may help as well. In more persistent or highly symptomatic cases, topical antihistamines, prescribed by your optometrist, may prolong the refractory period (the time it takes the nerve to signal the muscle to move) thus decreasing symptoms. In many cases, there is a response within 20 minutes of instillation. Anecdotally, quinine (found in tonic water) may also help calm this condition. One to two glasses a day for a week is often helpful however, this approach should be avoided in pregnant women.

If the twitches persist on a daily basis for two months or longer, they can generally be elimninated with a mild muscle relaxant or an injection of Botox. Myokymia that begins with one eyelid, but spreads to include other muscles of the face, requires further investigation. Some forms of eyelid twitching are caused by neurological conditions such as blepharospasm or hemifacial spasm. These conditions are much less common and are far more serious and should be evaluated more thoroughly by your eye care physician.

Please contact our offices in Stillwater at 405-372-1715 or Pawnee at 918-762-2573 with questions concerning this topic or any other eyecare related issues. We also invite you to visit our website at www.cockrelleyecare.com.