When Your Eyelid Keeps Twitching and Fluttering

One eyelid has been fluttering for days. It bothers you, but when you look in the mirror you can barely even see it.

A twitch like this usually makes people worry about a serious illness. Yet at the hospital, most people are told "it's because you're tired" or "it will go away soon." In fact, in many cases that is correct. Still, I read this common twitch as a small signal the body is sending to say it is worn out.

Why does the eyelid twitch?

The most common of eyelid twitches is the fine, ripple-like tremor of the orbicularis oculi muscle. It is not that the muscle itself is diseased, but a state in which the nerve moving that muscle is firing more sensitively than necessary. How easily nerves and muscles get excited is greatly influenced by the state of the body.

There is a common thread I often see in these patients. They are sleep-deprived, they have accumulated stress, they drink a lot of coffee, and they have overworked their eyes for long stretches. If, on top of this, the body's electrolyte balance tilts slightly or magnesium runs low, the nerve's threshold drops and it twitches more easily. The twitch appears at the spot where several conditions overlap and the nerve has become sensitive.

Fatigue and caffeine, stress and lack of sleep often come along with this kind of twitch. And it usually settles on its own.

I do not view this twitch as a problem of the eye alone. When the body as a whole is tilted toward excitation, the sign shows first in the thinnest, most sensitive eyelid muscle, in my view. So the twitch is closer to an early alert that the body is worn out, not a malfunction of the eye.

I settle whatever made the nerve so touchy

The twitch itself usually subsides within a few days to a few weeks. I look first, before the twitching eye, at the conditions that have made the nerve sensitive.

I examine whether you are short on sleep, whether you drink too much coffee, whether you overwork your eyes for long stretches, whether the tension will not release. When these conditions are settled, the twitch usually disappears on its own. If the twitch recurs often and is accompanied by other signs of bodily fatigue, I use herbal medicine on the fatigue piled up underneath rather than on the twitch. The twitch usually stops first, and the state that made it releases a little later.

Cases where you must go to a hospital first

That said, there are cases of eyelid twitching that must be distinguished. If the twitch spreads beyond the eye to the corner of the mouth or the cheek, if the eye clamps shut on its own so that it is hard to open, or if one whole side of the face twitches together and it continues for weeks or more, it may not be a simple fatigue twitch, so you should see a neurologist.

I do not claim that all eyelid twitching is explained by fatigue alone. If the signs above are present, I first recommend neurological testing.

Read the twitch as an early signal

A mild eyelid twitch is usually not dangerous. But I would advise you not to simply pass it off, and instead to read it as an early signal that your body is overdoing it right now. Even after the twitch disappears, the fatigue that had accumulated in that place remains. Let us relieve that fatigue together.

Written by Dr. Heo Ji-young (PhD in Korean Medicine Pathology, Kyung Hee University · former Research Professor of Herbology, Kyung Hee University)