Ophthalmology & Optometry/Upper eye lids


QUESTION: I've been experiencing upper eye lid twitching. Both eyes are affected, it goes back and forth. Some days the right is worse and some the left is worse. It's been off and on for a month. But, the past week it's been quite a bit more frequent. I've kept a log and the time between spasms ranges from 5 minutes to 45 minutes. So, it sometimes feels like it's constant.

I'm a healthy 39 year old female with no health concerns. I'm not experiencing any twitching anywhere else. My eye lids are not closing shut...not yet anyway.

I understand eye lid twitching is a normal phenomenon. I'm wondering if it's normal to persist for this long? Should I see a Physician?

ANSWER: Catherine,
The official name is benign lid myokymia.  If it is just a tremble / twitch, it's usually fine.  They're typically associated with stress, fatigue, lack of sleep, or too much caffeine.  It's usually a life-style issue, and usually temporary.  Work on those things if you can.
There are some ways to treat these, ranging from cold packs and antihistamine to a small botox injection.
If it's persistent or troublesome, I would schedule an appointment with your eye doctor. He or she can do some other tests in the office to rule out any more serious problems.  
Good Luck!

---------- FOLLOW-UP ----------

QUESTION: I appreciate your knowledge. Thank you. My concern is that it is bilateral and occurring so frequently. What are your thoughts on that?
I've had twitching before. But it's always 1 eye and only lasts 3 seconds. Then it will be months before it happens again.

I apologize, somehow I missed the notification that you had a follow-up question.  The bilateral nature isn't a concern any more than if it was just one eye.  The frequency could still very much be normal, but I always suggest patient's listen to their 'gut feeling.'  If it's concerning you, please make an appointment with your eye doctor.
Good Luck!

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John M. Dovie, OD, FAAO


As a residency-trained Fellow of the American Academy of Optometry I am able to answer most questions regarding eye and vision health. Anything is welcome, ranging from dry or allergy eyes, bifocal contact lenses, or thoughts on LASIK surgery. As I am not a surgeon, detail-oriented surgical-related questions may be better answered by an ophthalmologist.


Selected to participate in the PCO residency program in Philadelphia at The Eye Institute, where I worked OD and MD specialists gaining invaluable experience in various clinics including glaucoma, cornea and cataract, oculo-plastics, retinal disease, neuro-ophthalmic disease, primary care, emergency medicine, and special populations. Have practiced and trained in numerous settings including hospital, academic, retail and private practice. I earned my Fellowship in the American Academy of Optometry (FAAO). There are currently only about 3000 active fellows worldwide, and there are only about 70 Fellows in the state of Virginia. I currently own and operate my own optometric practice/clinic.

American Academy of Optometry, American Optometric Association (Contact Lens/Cornea Section member since 2001), Southwest Virginia Optometric Association, Virginia Tech Alumni Association

“Nyctalopia as the Presenting Sign of Vitamin A Deficiency: A Late Complication of Gastric Bypass Surgery.” Clinical Case Study Poster presented at The American Academy of Optometry Denver, Colorado, December 2006, co-authored with Bradley Lane, OD.
“The Importance of Considering Paranasal Sinus Mucocele as a Differential Diagnosis in Diplopia.” Clinical Case Study Poster presented at The American Academy of Optometry San Diego, California, December 2005, co-authored with Kelly Malloy, OD, FAAO and Cherie Farkash, OD.
“Acute Onset of Halos and Glare: Bilateral Keratitis—An Atypical Presentation of Amiodarone Keratopathy.” Clinical Case Study Poster presented at The American Academy of Optometry Tampa, Florida December 2004. Also Presented to New Jersey Academy of Optometry, Neptune, New Jersey March 2005.
“The Opportunity for an Optometrist to Save a Life.” Clinical Case Study and Grand Rounds Presentation presented at The Pennsylvania College of Optometry, Philadelphia, Pennsylvania, September 2004.
“Corneal whorls cause wonder.” Clinical Challenges Quiz, co-authored with Andrew Gurwood, OD, FAAO, Review of Optometry. Published 10/15/2006.
“Acute onset of halos and glare: bilateral corneal epithelial edema with cystic eruptions--atypical presentation of amiodarone keratopathy.” Co-authored with Andrew Gurwood, OD, FAAO. Published February, 2006, Optometry.
“Pondering the posterior polka-dots.” Clinical Challenges Quiz, co-authored with Andrew Gurwood, OD, FAAO, Review of Optometry. Published 5/15/2005.
Professional Involvement:
“AION: Amiodarone-Induced or Anterior Ischemic Optic Neuropathy?” Participated as a peer-review referee for Expert Review of Ophthalmology (London, UK); refereed 10/2006.

Bachelor of Science, Cum Laude, Virginia Tech. Bachelor of Science, Pennsylvania College of Optometry. Doctorate (OD), Pennsylvania College of Optometry Residency, Pennsylvania College of Optometry Fellow of the American Academy of Optometry

Awards and Honors
Winner, First Place, "Best Beside Manner" by Our Health Magazine: 2012, 2013, 2014 Winner, First Place, "Best Eye Doctor" by The Roanoke Times: 2013, 2014 Recognized as a Fellow of the American Academy of Optometry, December, 2006 Recipient of the Onofrey G. Rybachok Memorial Scholarship, 2000-2001 Member: The Golden Key International Honor Society Member: The National Biological Honor Society Member: The National Honor Society Eagle Scout awarded 1994

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