Does Your Eye Twitch When You Have a Headache?

An eye twitch (myokymia) is a benign condition that causes involuntary spasms of the eyelid.

An eye twitch is common and can be brought on by certain triggers, such as lack of sleep, caffeine, stress, and allergies. These triggers can also cause headaches.

This article will discuss common causes of eyelid twitching, why it may occur with a headache, and how to treat it.

Causes of Eyelid Twitching and Headaches

There are two types of headaches that can cause eye twitching: Migraines and cluster headaches.

Migraine

A migraine is a severe type of headache, technically classified as a neurological disease, that affects more than 39 million Americans. Symptoms of migraines include:

• Moderate to severe head pain that interferes with daily functioning
• Intense pain on one side of the head, both sides, in the front or back of the head, or around the eyes
• Head throbbing or pounding
• Head pain that worsens with movement and physical activity
• Nausea and vomiting
• Sensitivity to light
• Aura, flashes of light, blind spots, shapes, or bright spots that can cause blurred vision or loss of vision

These symptoms can last from four hours to several days and can result in eyelid twitching, especially if aura is present. 

Cluster Headache

Cluster headaches also referred to as Horton’s syndrome, cause a series of intense, cyclically occurring headaches, with each one lasting between one and three hours. Cluster headaches can occur every day and at multiple times. They often are linked to a sudden release of histamine or serotonin, or triggers like bright lights, exercise, heat, and alcohol use.

Symptoms of cluster headaches include:

• Sudden onset of pain around or behind the eyes
• Pain that builds in intensity within 10–15 minutes
• Restlessness or agitation
• Red or watering eyes
• Nasal congestion
• Eyelid drooping, swelling, or twitching

Other Causes of Eye Twitching

Mild eye twitching often occurs in response to:

• Stress
• Eye strain from prolonged reading or screen use with televisions, computers, tablets, and cell phones
• Certain medications
• Caffeine 
• Dry or irritated eyes
• Lack of sleep

These underlying causes may or may not also cause a mild headache.

How Long It Lasts

Benign eye twitching typically only lasts for a few days and resolves on its own. The twitching is often intermittent throughout the day, with periods of rest in between one or a few spasms of the eyelid. 

Eye twitching is rarely continuous throughout the day without stopping. Eye twitching that occurs with headaches often lasts until the headache symptoms resolve.

If eye twitching becomes worse or does not go away after one week, you may have a more serious medical condition causing eyelid spasms, tics, or tremors. Potential causes of ongoing eye twitching include:

• Bell’s palsy (paralysis of the facial nerve)
• Dystonia (movement disorder causing involuntary muscle contractions)
• Tourette’s syndrome (neurological disorder causing uncontrollable repetitive sounds or movements known as tics)
• Myasthenia gravis (autoimmune disorder causing muscle weakness)
• Multiple sclerosis (chronic disease of the brain and spinal cord)
• Parkinson’s disease (chronic, progressive nervous system disorder affecting movement)

Treatment

Eye twitching typically goes away on its own without treatment. You can decrease symptoms by getting more sleep, decreasing caffeine intake, avoiding exposure to bright lights and prolonged use of screens, and keeping your eyes moist with eye drops.

What's more, alleviating headache symptoms can help decrease eye twitching, and managing many of the triggers that can cause eye twitching can also help decrease the occurrence of headaches.

Medication used to treat headaches, including migraines and cluster headaches, consists of:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) and pain-relieving medications like Advil or Motrin (ibuprofen), Aleve (naproxen), and aspirin, or high-dose Tylenol (acetaminophen) to treat acute headaches and migraines
• Migraine prevention medications like Atacand (candesartan), Micardis (telmisartan), Zestril (lisinopril), Topamax (topiramate), Inderal (propranolol), Aimovig (erenumab), Ajovy (fremanezumab), and Emgality (galcanezumab)
• Medications like galcanezumab and triptans to reduce cluster headaches 

Injections of Botox (botulinum toxin), magnesium supplementation, high dose oxygen supplementation, and noninvasive vagus nerve stimulation may also be used to treat severe and ongoing headaches.

Underlying conditions causing eye twitching need to be treated and managed first to see any improvement. If severe or chronic eye twitching is unrelated to any neurological or eye condition, small Botox injections can be injected around your eye to decrease nerve impulses to the eyelid and resulting eyelid spasms.

When to See a Healthcare Provider

You should see your primary healthcare provider or eye doctor (ophthalmologist or optometrist) about your eye twitch if:

• Eye twitching lasts longer than one week.
• Twitching affects other parts of your face.
• Your eyelid droops. 
• You have difficulty opening or closing your eye.
• Your eye is red, swollen, or emitting a discharge.

These are possible signs of a neurological disorder or condition causing irritation to your eyelid, cornea (clear, protective outer layer of the eye), or conjunctiva (loose connective tissue covering the surface of the eye) of your eye.  

If your eye twitch only occurs with headaches, you should see your healthcare provider if:

• You experience severe and/or frequent headaches.
• Your headaches interfere with your daily functioning.
• You experience other symptoms like nausea, vomiting, or light sensitivity. 

Severe and recurrent headaches are possible signs of migraines or cluster headaches and require medical attention to treat and manage symptoms.

Summary

Eye twitching from headaches is a common symptom that goes away on its own, especially after headache symptoms resolve. Managing stress, reducing eye strain, and getting enough sleep are key for preventing both headaches and eye twitching. If your eye twitches result from migraines or cluster headaches, medication to manage your head pain and symptoms may be required to reduce the eye twitching.