It is very annoying and disturbing that the eyelid begins to shake, especially when you are in conversation with another person. It can happen to you after you’ve had little sleep (5 hours or less) and your third coffee of the morning.

This strange contraction that usually occurs in the lower eyelid, although it can also occur in the upper eyelid, is known as palpebral myokymia. In most cases it lasts a few seconds or minutes and resolves on its own.

WHAT ARE THE CAUSES OF EYELID TREMORS?

Usually, eyelid tremors or myokymias are triggered by stress, lack of sleep, having drunk alcohol or caffeine. It can also be the side effect of some medications, such as some indicated against migraine.

The contraction occurs when the orbicularis oculi, the muscle responsible for opening and closing the eyelids, begins to contract spontaneously. It occurs most often on the lower eyelid, in one eye at a time, and is usually not painful.

Once the spasms begin, they may continue intermittently for a few days.

Another type of tremor is blepharospasm, which can cause involuntary and complete closure of the eyelid, excessive blinking or other movements of the eyelids. It also occurs due to a contraction of the orbicularis oculi and may involve other muscles of the forehead.

More serious is hemifacial spasm, a neuromuscular disorder that involves involuntary contractions and jerks on
one side of the face. It can affect the eye, eyebrows, lips, mouth, and neck.

WHAT ARE THE TREATMENTS FOR EYE TREMORS?

Eyelid myokymia usually does not require treatment and usually goes away on its own. However, it can be helpful to reduce potential triggers, such as caffeine, alcohol, spending too much time in front of a computer or mobile screen, sleeping too little, or being stressed.

For quick relief from eye twitching, apply a warm compress to the upper eyelid area to relax the muscles around your eye. You can also put on a few lubricating drops.

In cases of blepharospasm and hemifacial spasm that do not cease or recur, botox (botulinum toxin) injections can prevent facial muscles from contracting.

In the case of blepharospasm that worsens in bright light, wearing polarized lenses may be helpful. In severe hemifacial cases, surgery is sometimes needed to relieve pressure on the affected nerves.

WHEN A TREMOR IS WORRISOME

If the tremor does not disappear in a few days, it is necessary to go to the doctor in case it could indicate the existence of an underlying disorder, especially if other symptoms occur, such as vision disturbances, weakness, difficulty moving or loss of sensation in the area.

See your primary care doctor or eye doctor if:

• The tremors do not go away within a week.
• The contractions close the eyelid completely.
• The contractions affect other parts of the face.
• The eye is red or swollen.
• The upper eyelid “droops”.

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