Definition
The three most common types of eyelid spasms are eyelid twitch, essential blepharospasm, and hemifacial spasm.
  • Eyelid Twitch
    The cause of minor eyelid twitching is unknown. A slight spasm of the lower eyelid or even both eyelids is common and of no concern.
  • Essential Blepharospasm
    An involuntary condition usually involving both eyes, where the eyelids, and sometimes the eyebrows, close involuntarily. In advanced cases of essential blepharospasm, muscles of the mouth or neck are sometimes involved in these spasms. When these spasms occur, temporary inability to see may result because of the involuntary eyelid closure. These spasms are rare but very troublesome, and often incapacitating. Blepharospasm is caused by abnormal nerve impulses producing muscle spasms, and almost never a psychiatric disease.
  • Hemifacial Spasm
    Hemifacial spasm is a condition which involves the eyelid muscles and usually the muscles around the mouth, but on only one side of the face. Hemifacial spasm is usually caused by an artery pressing on the nerve to the facial muscles causing the face to twitch.

Symptoms
  • Twitching or spasm around the eyes
  • Facial spasms
The symptoms described above may not necessarily mean that you have eyelid spasms. However, if you experience one or more of these symptoms, contact your eye doctor for a complete exam.

Treatment
Eyelid Twitch.
Minor eyelid twitches require no treatment as they usually resolve spontaneously. Reducing stress, using warm soaks, or correction of any refractive error may help. Some ophthalmologists recommend reducing caffeine usage.
Blepharospasm.
Can be treated with medications, biofeedback, injection of botulinum and surgery. Medications and biofeedback are rarely successful in managing blepharospasm, but may be advised in mild cases or cases not responding to other treatment. Botulinum injections are now the most commonly recommended treatment for blepharospasm. Injection of botulinum (botulism toxin) in very small quantities into the muscles around the eyes will relax the spasm. The injection works for several months, but will slowly wear off and usually needs to be repeated. The treatment is very successful with few side-effects. On those rare occasions when side-effects do occur, they include drooping of the eyelids, double vision or dryness of the eye, but they all subside as the injection wears off. Your ophthalmologist may suggest surgery to remove either the nerve causing the spasm or the spastic muscles themselves. The surgical results are generally permanent and any side-effects are also usually permanent. Hemifacial Spasm.
Botulinum injections may be beneficial in relieving the eyelid spasms in patients with hemifacial spasm. A neurosurgical procedure for hemifacial spasm may relieve the pressure of the artery on the nerve. While it is generally successful, it is a major neurosurgical operation and serious complications are possible.