Recently a friend of mine complained of a nonstop eye twitch, so, helpful friend that I am, I looked up “eye twitch” on WebMD for her. As is usually the case when someone with zero medical background consults WebMD looking for a diagnosis, this was a huge mistake. Of course I saw the early, so-called “most likely” causes—fatigue and stress—but I scrolled right past them on to the graver possibilities: brain or nerve disorders like Bell’s palsy, some kind of muscle disorder called dystonia, even Parkinson’s disease. Slightly panicked, I turned to my second-most preferred online health resource: the Mayo Clinic website. There I found even more possible diagnoses: glaucoma, multiple sclerosis, Tourette’s syndrome, and a few more conditions that sounded like space odyssey movie character names—entropion and uveitis, for instance. A search for “eye twitch + ALS” reveals a number of very concerned health forum posts from people who, like me, wish to jump to the worst possible conclusion. Much like headaches, it seems, eye twitching is the sort of symptom for which you can easily find dozens of possible culprits covering the full diagnostic range between “Eh, whatever” and “You’ll be dead tomorrow.”
Because I am the sort of person who would easily pick up an eye twitch after reading about it online, I figured I should reach out to a few experts who might be better able to help my friend and, eventually, I’m sure, me. Did I expect that one of these experts would be Eric Singer, drummer for the band KISS? No. I did not. But sometimes the best commonsense health advice comes from where you least expect it—like from the drummer of the band KISS.
First, though, I talked to Jenepher K. Piper, who, while not a member of a famous rock band, is a registered nurse and primary care practitioner at Mercy Medical Center in Baltimore. Piper tells me the most likely causes of eye twitching are fatigue, stress, and consuming too much caffeine. The latter two are highly related—stress causes your adrenaline to pump, not unlike a large cup of coffee (or, says Piper, taking drugs used to treat ADD, like Adderall). That adrenaline, in turn, can make your hands shake, and it can also make your eyes twitch. On the other end, fatigue means “your muscles aren’t getting enough nutrients,” says Piper. “Being low in vitamin D or magnesium can [lead to] difficulty with relaxing one’s muscles, so they kind of tense up,” or twitch.
A less common cause of eye twitching is hyperthyroidism, which Piper herself has. Anyone who is known to have a thyroid issue should consider their eye twitching a reason to see their doctor as soon as possible. Otherwise, it’s fine to just give an eye twitch some time to go away on its own: “If they don’t have a thyroid problem I wouldn’t rush to the doctor after a couple of days. I would probably give it a couple of weeks,” says Piper. Eye twitch sufferers should try not to fixate on their twitch, either, because anxiety can actually prolong the symptom. “Anxiety amplifies pain, it amplifies [twitching]—it can create a much worse problem than you began with,” adds Piper.
Randy McLaughlin, an optometrist at The Ohio State University Wexner Medical Center, understands why something as benign as an eye twitch makes people freak out. “People know it’s not right, they think it’s neurological, and they think this could be the first sign of something bad, like ALS. I don’t really think it’s proven that it is,” he says. “But your eyes are your most precious sense. And when something’s different or off with your eye or eyelid, people get scared.” And when people get scared, they go online. But McLaughlin says, here at least, they probably shouldn’t. “The internet is wonderful, it’s a wealth of knowledge, but sometimes it’s too much knowledge,” he says. When you find yourself with an eye twitch, it’s very, very likely the result of, well, being human: You’re tired, you’re stressed, and maybe you had a little too much coffee. It happens.
Toward the end of our call, McLaughlin apologizes, and says he has to do some name-dropping. I braced myself to hear a story about, like, a slightly more famous optometrist. But apparently, before he talked to me, McLaughlin was on the phone with his friend Eric Singer, who happens to be the drummer for KISS (and formerly, for Black Sabbath). McLaughlin says that when he told Singer about our impending interview about the causes of eye twitching, Singer said, “That’s easy. You don’t get enough sleep, too much caffeine, and you’re stressed, and you need to adjust your diet.” And if the drummer for KISS says so, it must be true.
For an otherwise healthy person, then, an eye twitch can serve as a useful reminder to take better care of oneself. The symptom’s link to more serious diseases like ALS is tenuous at best, and certainly incomplete—says Piper, “I really don't see [eye twitching] as a major heralding sign of Parkinson's or any movement disorder at all.” And while it’s technically possible eye twitching can be a sign of a more serious condition, it’s extremely unlikely to be the earliest or most noticeable sign of any of them. Infinitely more likely is that you’re simply stressed out. Two medical professionals and one rock star say your jumpy eyelid is no big deal. And if that isn’t enough to ease your mind, I really can’t help you.