A full exam by an Eye M.D. is necessary to determine the cause of the eye twitching and to rule out any underlying neurological disorder. In many cases no cause is found. In such cases, a diagnosis of benign essential blepharospasm is made.
Minor eye twitching does not require treatment because it usually disappears on its own. Reducing stress, increasing your amount of sleep and decreasing caffeine intake may help to relieve eyelid twitches.
There is currently no cure for blepharospasm, but several treatments can reduce its severity. The most common treatment involves injecting botulinum toxin–derived medicines into the muscles of the eyelids. The toxin paralyzes the muscles of the eyelids, reducing the twitching. The injections often improve symptoms, but the injections need to be repeated over time.
In more severe cases, myectomy, a surgical procedure to remove some of the muscles and nerves of the eyelids, is a possible treatment option. This surgery has improved symptoms in 75 percent to 85 percent of people with blepharospasm.