Ophthalmology

Eye twitching

introduction

Almost everyone has seen it in themselves: An irregular twitching of the upper or lower eyelid, better known as eye twitching.
From time to time we have to deal with this phenomenon, which is not really annoying, but a bit annoying. But what is the cause of this, and how can you get it back online? There are a number of causes for the twitching of the eyes, most of which are absolutely harmless. In rare cases, however, the illnesses can also be more serious and should be clarified by a neurologist.

You might also be interested in: Twitching of the face

Causes of eye twitching

The most common cause of eye twitching is overload in the broadest sense. This can be both physical and psychological in nature. A stressful week or burnout syndrome can just as easily make your eyes twitch, as can heavy exercise or exercise.
Especially in summer, profuse sweating can lead to an imbalance in the body's salt balance. With the sweat, sodium, potassium and chloride are excreted, minerals that the body urgently needs to transmit signals from its nerve impulses. The impulse transmission of the nerves takes place, for example, via the fine control of sodium / potassium channels. This transmission can be compromised when the body has lost too much fluids and minerals. The impulses cannot be passed on accordingly, muscle twitching occurs.

Since both the upper and lower eyelids are opened by muscles, the eyes twitch as a result. You can also observe the same thing in other muscles of the body, especially the calf muscles tend to twitch after a long hike.

In addition to the loss of minerals, stress and the so-called burn-out syndrome can also lead to twitching eyes. This is based on an over-excitability of the nerves, very similar to the proverb "the nerves are on edge". Constant nerve impulses and too little sleep lead to overexcitation of the nerve pathways. The only thing that helps here is taking a break, both professionally and physically, as the twitching of the eyes is by far not the worst symptom that can be caused by permanent stress.

Anyway, a twitching eye is usually not a symptom to be overly worried about. It usually disappears within minutes to hours, just as suddenly as it appeared. However, if it does not subside over a longer period of time (days), a visit to a neurologist or family doctor should take place. In addition to the easily treatable causes mentioned above, an eye twitch can also be based on a more serious illness.

Learn more at: What can be causing eye twitching?

Stress as a cause of eye twitching

One of the most common triggers for eye twitching is stress. Fatigue and long, strained looking at the computer screen also contribute to the overloading of the eye muscles.
It is often enough to just relax for a moment and the annoying twitching of the eye will disappear.Chronic stress can cause the twitching to persist for a long time. Since this form of stress is very exhausting for the body and leads to health problems in the long run, those affected should definitely react.
Relaxation methods, yoga and endurance sports such as running, cycling or swimming help reduce stress and increase physical wellbeing.

Neck tension

When the eyelid twitches uncontrollably, it can sometimes be related to the neck. Although many people consider the eyes and neck to be functionally separate, they are closely related and neck tension can have a major impact on the entire body. Bad posture and the resulting muscle tension can extend into the head and thus also affect the eye muscles. This leads to eye discomfort and twitching. Concomitant symptoms are often headache, dry eyes, and vision problems.
When the painful neck tension is treated, the twitching of the eyes usually improves quickly. Warmth, massages and endurance sports train the back and shoulder muscles and help against tension.

Contact lenses as a trigger for eye twitching

Contact lenses can cause minor injuries to the cornea of the eye. As a result, the eye is irritated and the nerves send uncontrolled signals to the eye muscles, which then quickly contract repeatedly. If there is a corneal injury, those affected should first forego the lenses and switch to glasses.
Normally, the cornea regenerates very quickly (usually within 24 hours) with minor damage and the annoying twitching of the eyes is completely gone after a few hours to days.

More on this:

The right contact lenses
Adjust contact lenses

Eye twitching from alcohol consumption

Another cause of eye twitching can be increased or disproportionately long alcohol consumption for days. In a certain way, this is also a physical stressful situation that is accompanied by a derailment of the electrolyte balance. If there has been a high level of alcohol consumption in the last few days, eye twitching may well occur as a result. It makes sense to limit alcohol consumption for the time being, not only because of the twitching eyes. To treat acute symptoms, electrolyte solutions such as Elotrans are recommended.

These are actually intended for electrolyte imbalances after diarrhea. However, alcohol consumption for several days is sometimes based on the same problem, excessive elimination of electrolytes.
If it is not about several days but several years of heavy alcohol consumption, one speaks of alcoholism. For alcoholics, twitching not only of the eyes but of the entire body (so-called withdrawal tremor) is very typical, especially in the withdrawal phases. Alcoholics often cover all of their calorie needs with alcohol and otherwise do not consume any food. This leads to a vitamin B1 or thiamine deficiency. This is also shown by muscle twitching and loss of sensitivity.

The eyes can also be affected. You can get rid of the twitch in this case by substituting thiamine. In this case, this is absolutely essential for survival, as sooner or later all muscles - including the heart muscle - will fail. The withdrawal tremor is self-limiting, so it usually resolves itself within a week. The drug distraneurin can be administered as a support. In order to combat the cause, however, abstinent consumer behavior on the part of the patient is essential.

Thyroid eye twitching

Eye twitching can also be caused by a malfunction of the thyroid gland. The thyroid is an approximately 20 ml small organ located in the area under the larynx. Its main task is the production of hormones, more precisely the hormones T3 and T4. Both are responsible for the energy turnover in the body and, to a certain extent, for the drive.
An excessive production of the hormones T3 and T4 lead to nervousness, sweating, racing heart, but also muscle twitching. The eye can also be affected by this muscle twitch. A twitch of the eye can therefore also be a sign of hyperthyroidism, i.e. an overactive thyroid. However, a few other questions must be clarified in order to establish the diagnosis. The simplest method for clarifying hyperthyroidism is diagnosis using a "small blood count". The control hormone for the hormones T3 and T4, the TSH, is measured. If it is too low, it indicates an excessively high level of the hormones T3 and T4. After all, when the T3 and T4 levels are high, the body cuts down the production of these hormones, which is done by lowering the TSH level. Incidentally, T3 and T4 are not determined directly, as proof would cost several hundred euros, while the TSH measurement is in the range of a few euros.
An overactive thyroid can be present when the eyes are trembling, but this does not necessarily have to be the cause. In this case, you can get rid of the eye tremors by lowering the T3 and T4 mirrors. This is done with medication by taking appropriate preparations (so-called thyreostatics), and is a relatively common and uncomplicated therapy. A clarification of the TSH values at regular intervals must, however, be carried out regularly by the family doctor in the further course.

Can twitching eyes also be triggered by a vitamin deficiency?

A lack of vitamins and minerals can make your eyes twitch. There is often a vitamin B12 deficiency.
Vitamin B12 is involved in blood formation and contributes to the functionality of the nerves. A deficiency leads to permanent exhaustion, exhaustion and anemia. The nerves can also be impaired, which is why muscle twitching and abnormal sensations can occur.
Vitamin B12 deficiency is particularly widespread among vegans and vegetarians. However, adolescents and pregnant women also need more vitamin B12 due to the increased metabolic activity.
Another cause of eye twitching is a lack of magnesium. Magnesium is a mineral that we have to take in through food and that ensures that the transmission of stimuli from the nerves to the muscles works. A deficiency is accordingly noticeable through involuntary muscle twitching, eye twitching and muscle cramps.
A balanced and varied diet helps to prevent malnutrition and to supply the body with sufficient vitamins. In the case of severe deficiency symptoms, the missing vitamins can also be supplied in the form of preparations. The doctor can use a simple blood test to determine whether there is a vitamin deficiency and whether this is causing the eye twitching.

Can multiple sclerosis be the cause?

In very rare cases, eye twitching can also occur in multiple sclerosis.
With this rare disease of the nervous system, there is a progressive decrease in nerve conductivity due to inflammation.
The optic nerve is affected relatively often, which can also be expressed in an eye twitch.
However, this is rather unlikely: Typical symptoms of optic nerve inflammation include impairments in vision itself, such as blurred vision or color vision disorders.
It should be noted: in a large number of cases, the eye is affected in the early stages of multiple sclerosis, but eye twitching is rather atypical for this - nevertheless, one reads the opposite in some Internet forums and information sites.

If the eyes are twitching, multiple sclerosis is only a diagnosis of exclusion, i.e. a diagnosis that is only made when all other possible causes have been safely ruled out.

Can twitching eyes be an indication of a brain tumor?

In extremely rare cases, an eye twitch can also be an indication of a brain tumor. This is a malignant growth within the skull that, as it grows, displaces healthy areas of the brain. Depending on where the tumor is and how fast it is growing, different symptoms can arise. Symptoms of paralysis, language problems, fever, nausea, headache or even muscle twitching are common.
Overall, brain tumors cause very diverse and unspecific symptoms. Therefore, twitching eyes alone is not necessarily an indication of the presence of a tumor. However, if the eye twitching persists over a long period of time, it makes sense to consult a doctor who will perform a neurological examination.
In the end, space within the skull can only be reliably detected by imaging methods, usually a magnetic resonance scan (MRI) of the head.

Eye twitching during pregnancy

Eye twitching can occur more frequently during pregnancy and while breastfeeding. The cause is often a vitamin deficiency. Pregnant women are at increased risk of vitamin B12 deficiency because the baby has to be looked after. Deficiency symptoms increased the likelihood of muscle twitching all over the body, including the eye muscles.
But stress or fear of childbirth can also cause the eyes to twitch. In addition, pregnant women often have sleep problems, especially in the last few weeks before giving birth, and suffer from extreme exhaustion and fatigue during the day. These factors make the eye muscles twitch.

Other causes

If a foreign body sensation occurs in the eye, the twitching may also result from an injury to the cornea.
This can be caused by any excessive strain on the eyes. Typically, the cornea shows small abrasions after contact with branches or small twigs. One then speaks of a so-called Erosio Cornae. Since the cornea regenerates within a few days, this is not a problem. Until then, however, there may be reddening, pain and increased blinking or twitching of the eye.
Other causes of an injury to the cornea can be welding work without protective goggles (so-called "flashing"), or contact with acids or alkalis, which are sometimes contained in cleaning agents. The latter, however, are an absolute emergency and should be treated immediately by irrigation and presentation to an ophthalmologist. There is a risk of loss of sight. In the healing phase or in some areas also in the acute phase, the eyes may twitch because the eye is exposed to constant pain stimuli.
In the case of injuries to the cornea, in addition to simply waiting in extreme cases, an ointment containing cortisone or Bepanthen ointment can also help. These are applied to the eye and accelerate the healing process.

Eye twitching on the upper eyelid

The upper eyelid is made up of a ring-shaped muscle, a connective tissue plate and the overlying skin layer. The muscle is used to close the eyelid and this can be done either arbitrarily or in the form of a reflex (eyelid closure reflex). When the upper eyelid twitches, uncontrolled transmission of stimuli by the nerves to the eye muscles leads to a series of rapid, involuntary muscle contractions, so-called fasciculations. We find fasciculations of the upper eyelid particularly uncomfortable, because the fluttering is literally always “in front of your eyes”. In most cases, an eye twitch on the upper eyelid does not have any disease value. Common causes are fatigue, nervousness or stress.
Alcohol consumption, lack of fluids or a lack of minerals in the body can also cause the twitches. Rarely is there a serious illness such as multiple sclerosis, inflammation of the brain or a tumor.
Occasional eye twitching on the upper eyelid does not need further treatment. Most of the time it is enough to recover and try to get enough sleep. Acute twitching upper eyelids can be treated with a gentle massage. Carefully run your fingers over the upper eyelid in the direction of the temple.

Read more on the topic: Eyelid twitching

Therapy of eye twitching

The therapy has already been explained for the diseases mentioned above. In general, relaxation, a balanced diet rich in vitamins and, for acute therapy, magnesium help. Magnesium is available in tablet or powder form for oral use and is available from any pharmacy.
Massage, meditation or yoga can be used as relaxation methods. In principle, there are no limits to your imagination, sometimes an evening in the bathtub is enough. In terms of nutrition, especially fresh fruit, vegetables and food rich in trace elements are recommended.
If you suspect excessive stress is the trigger for your eye twitching, it will also help to take a break from your job and, if possible, take a vacation. It should be borne in mind that in the majority of cases eye twitching can be traced back to stress, and this can also lead to high blood pressure and arteriosclerosis. These comorbidities represent high risk factors for much more dangerous diseases such as cerebral hemorrhage and heart attack.

homeopathy

Various homeopathic remedies are used to relieve twitching of the eye muscles. These include Kalium phosphoricum, Stramonium and Agaricus mascarius.
Since the twitches are often an expression of inner tension, calming substances such as hops, valerian or passion flower are also used. It is taken in the form of tablets, drops or globules. The homeopathic remedies are chosen to best suit the cause of the eye twitching.
If symptoms persist, however, a doctor should be consulted, as homeopathic remedies are not a substitute for therapy in severe neurological diseases.

Schüssler salts

For some people, the use of Schüssler salts for eye twitching has proven itself.
Schüssler salts are preparations from alternative medicine, but their effectiveness has not been scientifically proven. The following Schüssler salts can be taken for nervous eye twitching: No. 9 Sodium phosphoricum and No. 11 Silicea. It is taken in the form of tablets. An amount of 3 x 2 pieces per day is recommended.

forecast

The twitching of the eyes normally disappears within a few hours to a maximum of days. If it persists longer, a visit to the general practitioner or a neurologist is advisable.

In the event of damage to the eye or any impairment / impairment of the visual field, the ophthalmologist should be consulted immediately. Diseases of the eye are to be taken very seriously, especially in the event of rapid and acute deterioration, and often have a poor prognosis. It is crucial to act quickly in order to keep the consequential damage as low as possible. Epidemiologically, the number of burnout patients in industrialized countries has been increasing for years. Symptoms such as eye twitching or stress reactions will therefore continue to increase in their prevalence in the coming years.

Concomitant symptoms

Characteristically, the twitching affects only one eye, twitching in both eyes at the same time is atypical. The eye twitches several times in quick succession before the flutter disappears again. It may reappear after a while.
Eye twitching can occur alone or - depending on the cause - be accompanied by other symptoms. Usually there are psychological causes behind a twitching eye, such as tension, nervousness or stress. But overexertion of the optic nerve or lack of sleep also cause eye twitching. Accordingly, the accompanying symptoms include restlessness, fatigue or headaches.
Cardiovascular complaints such as high blood pressure, rapid heartbeat, dizziness or shortness of breath can also accompany twitching eyes.
If an overactive thyroid is behind the involuntary muscle twitching, those affected usually also suffer from extreme nervousness, mood swings, irritability and exhaustion. In addition, patients sweat more and have hot flashes.

anatomy

In order to understand exactly what “eye twitching” actually is, one should first clarify the anatomical relationships: The eyeball is located in the bony eye socket. It is surrounded by fatty tissue for cushioning and is therefore softly embedded. Towards the rear, the eye socket tapers conically (like a cylinder) so that at the end only a small opening remains for the optic nerve exit. The eye is protected from the front by the eyelids.
The eyelids form a protective and closing mechanism towards the front. A cartilage plate has grown into the eyelid, the so-called eyelid cartilage. It prevents damage to the underlying eyeball in the event of blows or blunt violence by absorbing and distributing the force.The eyelids are actively opened via the upper and lower lid lift muscles. The eyes are closed by the Orbicularis oculi muscle, or also called the eye ring muscle. It is ring-shaped around the eye and narrows the eye opening when it contracts.

You can observe this very well in the mirror: if you close one eye, you will see that the upper and lower eyelids do not move perpendicularly towards each other, but rather slide towards each other in a slightly circular movement. The interaction of the muscles mentioned above causes the eyes to twitch in the event of a malfunction.