Optician India

Welcome to question of the day #33

Why do some patients complain of jumpy or twitchy eyes?

This is a common, annoying complaint in which 98% of cases haveunilateral involvement, but often a history of contralateral attacks. It consists ofspasms in one or both eyelids of one eye. The patient notices the spasmsas very obvious and thinks that other people nearby can also see these spasms. In fact, the spasms are so slight that other people can only see them if they get very close to the patient. The patient’s own close proximity to the spasms makes them seems more obvious that it actually is. This phenomenon is called blepharomyokymia.

Predisposing factors are, fatigue, stress, caffeine, other stimulants, CNS depressants, decongestants, possible ocular fatigue due to small uncorrected refractive error, especially slight astigmatism for people with work that involves a demanding visual task.

The underlying cause is orbicularis fatigue, leading to spasms, causing more fatigue, and more spasms.

Management consists of reassurance, advice to reduce intake of stimulants, reduction in stress, increased rest and relaxation, attempts to enhance quality of sleep, and where clinically appropriate correction of small refractive errors, recommendation of topical anti-histamine drops 4-5 x daily and/or oral anti-histamine. If the medication route is taken, efficacy can be assessed after 4-5 days.