The most common things that make the muscle in your eyelid twitch are fatigue, stress, and caffeine. Once spasms begin, they may continue off and on for a few days. Then, they disappear. Most people experience this type of eyelid twitch on occasion and find it very annoying. In most cases, you won't even notice when the twitch has stopped.

More severe contractions, where the eyelid completely closes, are possible. These can be caused by irritation of the surface of the eye (cornea) or the membranes lining the eyelids (conjunctiva).

Sometimes, the reason your eyelid is twitching cannot be identified. This form of eyelid twitching lasts much longer, is often very uncomfortable, and can also cause your eyelids to close completely.

Eyelid twitching usually disappears without treatment. In the meantime, the following steps may help:

• Get more sleep.
• Drink less caffeine.
• Lubricate your eyes with eye drops.

If twitching is severe, small injections of botulinum toxin can temporarily cure the spasms.

The outlook depends on the specific type or cause of eyelid twitch. In some cases, the twitches usually stop within a week.

Permanent eye injury from unrecognized cornea injury is possible, but rare.

Call your primary care doctor or eye doctor (ophthalmologist) if:

• Eyelid twitching does not go away within 1 week
• Twitching completely closes your eyelid
• Twitching involves other parts of your face
• You have redness, swelling, or a discharge from your eye
• Your upper eyelid is drooping

Faucett DC. Essential blepharospasm. In: Yanoff M, Duker JS, Augsburger JJ, et al, eds. Ophthalmology. 2nd ed. Philadelphia, Pa: Mosby Elsevier; 2004: chap 91.