What is blepharospasm A blepharospastic twitch is an involuntary, abnormal blink or eyelid movement that can occur once every few seconds, sometimes even with closed eyes. The spasms can last anywhere from a few days to a few months, or they can appear randomly and without warning and then return quietly without a trace. Although it is not painful, it is rather annoying. For most people, blepharospasm will eventually go away on its own, but sometimes it will reappear. Remember to see your eye doctor if: The blepharospasm lasts for more than 1 week. Each eyelid twitch occurs with a closed eye. There is redness, swelling or discharge from the eye, or a droopy upper lid. Rarely, blepharospasm may be an early sign of a chronic movement disorder if there are spasms of other facial muscles other than blepharospasm. Therefore, if twitching or spasms of other facial muscles are found, they need to be identified as soon as possible. The cause of blepharospasm twitches Blepharospasm twitches are usually associated with abnormalities in the basal ganglia, the brain’s muscle movement center. Blepharospasm can occur in anyone, but the cause of each specific blepharospasm is often difficult to determine. Blepharospasm often occurs without warning, and sometimes the twitching subsides or even disappears completely after sleep or distraction. The following factors are associated with the development of blepharospasm and may exacerbate the twitching: alcohol, caffeine, fatigue, irritation of the eye surface or inner surface of the eyelid, lack of sleep, physical overwork, smoking, stress, and in rare cases, genetic factors may play a role in the development of blepharospasm. The development of blepharospasm may be preceded or accompanied by an eye condition such as blepharitis, dry eye, photophobia, or red eye (conjunctivitis). It is recommended that an eye exam be performed to find the cause of the blepharospasm, except for underlying neurological disease. Although in most cases the cause is not found, a diagnosis of benign idiopathic blepharospasm is made. Mild blepharospasm often resolves on its own and therefore does not require treatment. Reducing stress, getting more sleep, and drinking less coffee can help relieve the eyelid twitching. There is no cure for blepharospasm, but there are several ways to relieve the level of spasm, the most common of which is to inject botulinum toxin extract into the eyelid muscles, which paralyzes the muscles and reduces the spasm. Therefore, the medication often improves the symptoms after injection, but often requires repeat injections. In more severe cases, myotomy, the surgical removal of part of the eyelid muscle and nerve, may be required. This procedure can improve symptoms in 75 to 85 percent of patients with blepharospasm.