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The Real Reason Your Eye Goes Twitchy


Doctors call it benign fasciculation, that annoying, rippling feeling in your eyes that… what, signals a heart attack? Tells you a storm’s a-comin’? That you should bet that eight or put it all on Paint the Town Red in the fourth? Unfortunately, none of the above.

According to Dr. Wayne T. Cornblath, MD, a professor of ophthalmology, visual science and neurology at the University of Michigan, benign fasciculation is typically a sign that you’re stressed, over-caffeinated, under-nourished, or just plain tired. It’s no surprise you’re more susceptible while you’re sitting in traffic, in the midst of knocking back another Venti boilermaker, en route to that presentation that will make or break your career.

“Benign fasciculation is brought on by all the stuff of modern life,” Dr. Cornblath explains. As to severity, he’s quick to add that even if lingers, there’s no cause for immediate alarm. “Sometimes it persists, perhaps for a few days or even longer,” he says. “If goes more than a month, get it evaluated.”

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“To be honest, sometimes these things are related,” says Rebecca Taylor, M.D., a spokesperson for the American Academy of Ophthalmology. “You’re stressed, so you can’t sleep, and then you drink a lot of coffee or soda to stay awake. Then you get an eye twitch. Not uncommon.”

Sometimes benign fasciculation can progress to mimic a more serious condition called hemifacial spasm, where your cheek and lower face get into the act, along with your eyelid. You walk around feeling like the Batman super-villain Harvey “Two Face” Dent, and probably the more over-the-top Tommy Lee Jones version as opposed to the slightly more reserved portrayal by Aaron Eckhart.

While Dr. Cornblath agrees that this can be incredibly annoying, it’s basically a short circuit in a facial nerve firing off when it’s not supposed to.

“It’s like a check-engine light in your car coming on, but then you take it in, find nothing, and have the mechanic just turn it off,” he says.

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All that’s typically required is an MRI, to make sure there’s nothing out of the ordinary. Rarely—perhaps in one in 200 patients— the MRI will reveal a tumor pressing on a patient’s facial nerve. If it’s nothing serious but the symptoms are still persistent, your doctor might recommend Botox injections.

“Botox paralyzes muscles, which makes it an effective treatment if the twitching doesn’t go away just on its own or after changing lifestyle or diet,” says Taylor.

If you want to keep your lids languid, pay attention to when they start to twitch. Is it after that fifth cup of coffee? Did the boss chew you out? Did you just get a call from your bookie consisting of diabolical laughter? 

The twitch is nothing to get in a twist about. Ride it out, think about the reason why it’s happening more than the fact that it is, and enjoy the half-a-minute or so you get to look like Lee Van Cleef in a Sergio Leone flick.

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