Eye Twitching: Causes, Symptoms, and When to Seek Help

Q: Eye Twitching: Causes, Symptoms, and When to Seek Help

Hello： Your symptoms may suggest myofascial pain syndrome in the posterior neck muscle group, which can also lead to referred discomfort in the eyes. <br>The key issue lies within the muscles of the posterior neck. <br>The myofascial connection points are located in the forehead

The lower eyelid has been twitching intermittently for a week?

For a week, my lower eyelid has been twitching (since Sunday).
That morning, I woke up feeling some swelling at the outer corner of my upper eyelid and lower eyelid.
I thought it was just normal edema, so I didn't pay much attention to it (although I rarely experience swelling).
I went through the day as usual, but by evening, the sensation persisted.
Feeling a bit concerned, I went to the emergency room.
The doctor conducted various tests for stroke and facial nerve disorders, including a CT scan of my brain, and found no significant issues.
Later, I visited another family medicine clinic, where the doctor said my eyes were overly fatigued and advised me to rest more.
He also prescribed medication.
Indeed, during the winter break, I had been staying up late (around 2 or 3 AM) playing on my phone.
I followed the doctor's advice, especially since it was the last day of winter break, and went to bed early (around 10 or 11 PM).
I also did warm compresses (once a day for about 10 minutes), but the medication didn't seem to help; in fact, the twitching continued even after taking it.
However, I did take the medication and applied warm compresses, and I also reduced my phone usage.

I commute to school by train for an hour, which sometimes makes me feel a bit carsick, potentially increasing my eye pressure and causing a feeling of fullness.
During those two days (Wednesday and Thursday), I had to use the computer more to prepare for an interview and write my resume.
Then, on Thursday night, I developed a sore throat that kept me awake.
On Friday, I had a runny nose and a very sore throat, but it was only on the left side, with nasal congestion and yellow-green mucus.
The left side of my throat hurt more.
On Saturday morning, I saw an ENT specialist who diagnosed me with sinusitis.
I am writing this inquiry on Saturday night.

How can I determine if my eyelid twitching is not improving? The muscles below my eyelid have a strange sensation; initially, I thought it was swelling, but now I feel it is stiff.
There is no pain or numbness (I've heard that numbness can feel like a light touch, but I can still feel it).
It could also be that I'm overly concerned about it.
At that time, I also felt some tightness and stiffness in the muscles of my left upper lip (which could be related to the sinusitis, but I'm not sure).
The twitching occurs in the lower eyelid at the inner corner (where I often have eye discharge), the middle of the lower eyelid, and the outer lower eyelid (the upper part of the cheekbone).
However, there is no drooping of the mouth or asymmetry when my face is neutral or when I smile.
When I smile broadly, the right eye bag seems deeper, while the left eye bag is raised but not as sunken.
The area that is not sunken twitches occasionally, but then it seems to twitch less.

I've researched a lot, but the information is quite similar, and it doesn't seem like a stroke.
If it were facial nerve paralysis, I would expect more pronounced symptoms within a day or two.
However, I've also read that eyelid twitching can precede facial nerve paralysis after a few days.
How many days does that typically take? Additionally, I've seen claims that facial nerve paralysis can occur after a cold, so will I experience facial nerve dysfunction after recovering from this cold (sinusitis)? The ENT doctor mentioned that sinusitis could also cause eyelid twitching, but could that happen a week in advance?
If it is indeed facial nerve dysfunction, what methods are available for early detection and treatment to prevent facial changes? Today, the sensation in my upper lip muscles has decreased, but could this be due to the swelling from sinus fluid? Will I continue to experience this strange sensation even after recovering from the cold? I noticed that lifting the flesh around my mouth (near the cheekbone) reduces that strange sensation, but when I bend down or lie on my left side, the flesh on my face protrudes more, causing more twitching.
Specifically, just after doing that action, it twitches a couple of times.
When lying down, it twitches normally, but it twitches less when sitting or standing.
A week ago, it twitched less frequently, but now it twitches more often.
Is this improvement or worsening? The twitching gives a feeling of pressure release, while not twitching feels constricted.
The twitching can last for a few minutes or hours, with occurrences of one twitching episode every few minutes or once an hour.

I would appreciate your guidance on these questions.

Ms. Hsu, 20~29 year old female. Ask Date: 2018/03/03

Dr. Jiang Junyi reply Neurology

Hello: Your symptoms may suggest myofascial pain syndrome in the posterior neck muscle group, which can also lead to referred discomfort in the eyes.
The key issue lies within the muscles of the posterior neck.
The myofascial connection points are located in the forehead area.
I'm not sure if you have dry eye syndrome? When you overuse the shoulder and neck muscles, especially while using electronic devices, the local muscles can become tense and uncomfortable.
Additionally, during a cold, the accumulation of lactic acid can increase, making the symptoms more pronounced.
I recommend that you supplement with B vitamins during the day and develop a habit of stretching every half hour.
Typically, unstable neuromuscular conditions can improve within about two weeks with rest and treatment.
I suggest you consult a neurologist or a rehabilitation specialist for further evaluation and treatment.
Wishing you good health and peace.
Dr.
Tao cares about you.

Reply Date: 2018/03/03

More Info

Eye twitching, also known as myokymia, is a common condition that can be quite bothersome. It often manifests as involuntary spasms of the eyelid muscles, particularly the lower eyelid. Understanding the causes, symptoms, and when to seek medical help is crucial for managing this condition effectively.

Causes of Eye Twitching
1. Fatigue and Stress: One of the most common triggers for eye twitching is fatigue, particularly from lack of sleep or excessive screen time. In your case, you mentioned staying up late and using your phone extensively, which can lead to eye strain and fatigue. Stress can also exacerbate muscle spasms, including those in the eyelids.

2. Caffeine and Alcohol: High consumption of caffeine or alcohol can lead to increased muscle excitability, which may trigger twitching. If you consume these substances regularly, consider reducing your intake.

3. Dry Eyes: Prolonged screen time can lead to dry eyes, which can cause irritation and result in twitching. If you experience dryness, using artificial tears may help alleviate the symptoms.

4. Nutritional Deficiencies: Deficiencies in certain nutrients, particularly magnesium, can lead to muscle spasms. Ensuring a balanced diet rich in vitamins and minerals is essential for muscle health.

5. Underlying Medical Conditions: While less common, persistent eye twitching can be associated with neurological conditions or other medical issues. If twitching is accompanied by other symptoms, such as facial weakness, it is essential to seek medical attention.

Symptoms of Eye Twitching
The primary symptom is the involuntary twitching of the eyelid, which can vary in intensity and duration. Other associated symptoms may include:
- A feeling of tightness or discomfort around the eye.

- Increased sensitivity to light.

- Eye fatigue or strain.

In your case, you also mentioned experiencing a sensation of swelling and tightness in the muscles around your eye, which could be related to the fatigue and stress you are experiencing.

When to Seek Help
While occasional eye twitching is usually harmless and resolves on its own, you should seek medical attention if:
- The twitching persists for more than a week.

- You experience other symptoms, such as drooping eyelids, facial weakness, or changes in vision.

- The twitching interferes with your daily activities or causes significant discomfort.

Given that you have already undergone a CT scan and other evaluations that ruled out serious conditions like stroke or facial nerve disorders, it is likely that your symptoms are related to fatigue and stress. However, if your symptoms persist or worsen, it is advisable to follow up with a healthcare provider.

Management Strategies
1. Rest and Sleep: Prioritize getting adequate sleep and rest your eyes regularly, especially if you are working on screens for extended periods. The 20-20-20 rule can be helpful: every 20 minutes, look at something 20 feet away for at least 20 seconds.

2. Reduce Screen Time: Limit your use of electronic devices, especially before bedtime. Consider using blue light filters on your devices to reduce eye strain.

3. Stay Hydrated: Drink plenty of water and consider using artificial tears if you experience dryness.

4. Manage Stress: Engage in stress-reducing activities such as yoga, meditation, or deep-breathing exercises.

5. Consult a Doctor: If your symptoms do not improve with these measures, consult an eye specialist or a neurologist for further evaluation and management.

In summary, while eye twitching can be annoying, it is often benign and related to lifestyle factors such as fatigue and stress. By implementing some lifestyle changes and monitoring your symptoms, you can often alleviate the twitching. However, do not hesitate to seek medical advice if you have concerns about your symptoms or if they persist.

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