Have you ever had a sensation that felt like a “butterfly in your eye”? That’s exactly how one MyMSTeam member describes eye twitching with multiple sclerosis (MS).

MS often causes eye problems like double vision and pain. But eye twitches are not as common.

Here’s how eye twitching may be related to MS, along with tips that may help.

What Causes Eye Twitching in MS?

MS is an autoimmune disease, which means the immune system mistakenly attacks healthy tissue. It affects the central nervous system (CNS), including the brain and spinal cord. MS damages the protective myelin sheath that surrounds nerves in these areas.

Because any part of the CNS can be affected, MS may cause symptoms such as vision problems, muscle weakness, tingling, and numbness.

How MS Can Lead to Eye Twitching

Your brain and nerves control how your muscles work. When they’re damaged, your muscles can work differently.

Just as MS affects the nerves that control the larger muscles of your arms and legs, it can also affect the nerves that control the small muscles of your eyes and eyelids. Damage to these nerves can cause muscle weakness, making eye movements harder to control. It can also lead to muscle spasms and twitching.

Typically, eye twitching is associated with changes in a part of the brain called the basal ganglia. As eye twitching has been studied more, the cause seems to be a bit more complex, involving multiple brain areas, as well as imbalances in chemical messengers called neurotransmitters. All of these structures and substances can be affected by MS.

Different Types of Eye Twitching

People with MS may have primary or secondary twitching. In primary eye twitching, the twitch is spontaneous and unrelated to other conditions. In secondary eye twitching, the twitch is the result of something else, such as MS.

Doctors may also classify types of eye twitching based on which muscles and eye structures are affected. Eyelid muscles may twitch, causing your eye to suddenly blink or making it harder to open. You may also have wavelike muscle contractions in your eyelid, which might be what the MyMSTeam member described as the butterfly sensation.

The muscles that move your eye in different directions can also spasm, causing uncontrolled eye movements. This may occur with conditions such as nystagmus or internuclear ophthalmoplegia (INO), depending on which muscles are affected. About 23 percent of people with MS have a period of INO.

What Does It Feel Like?

One member of MyMSTeam described their eyelid twitch as “extremely annoying and uncomfortable,” while another member stated, “It drives me crazy.”

An eyelid twitch can make it hard to open your eyes, may lead to more frequent blinking, or may cause small, wavelike muscle spasms.

If the eyeball itself is moving, it may feel like you have trouble controlling your eye movements. It may also be hard to hold a steady gaze.

On MyMSTeam, a member described their eye movement as “droopy” because the eyeball wasn’t going where they wanted it to. Another member who noticed the twitch while they were reading said, “I have problems keeping track of where I am in the book.”

In people with MS, eye twitches most commonly happen on both sides.

Other Causes and Triggers of Eye Twitching

In addition to the effects of MS on the CNS, several other factors can cause or worsen eye twitching:

• Stress and anxiety
• Genetics
• Caffeine intake
• Fatigue
• Eyestrain
• Bright lights
• Irritation of the eye, such as dry eyes
• Alcohol and nicotine intake

Members of MyMSTeam discuss when they notice their eyes twitching more:

“My right eye gets twitchy sometimes. I think it’s mostly when I’m really stressed out.”

“I figured it was from my 9-year-old stressing me out.”

“I noticed my eyes twitch more after a long day.”

“Mine is worse during the colder months, when the heat is on. I equate it with the drier air in the winter.”

Does Medication Play a Role?

Certain medications can also cause eye twitches. Specifically, medications used to treat seizures (such as topiramate) and Parkinson’s disease (carbidopa and levodopa) are known to have eye twitching as a side effect.

Because dry eyes can cause eye twitching, medications that cause dry eyes may also make your eyes twitch. Examples include antihistamines, antidepressants, and diuretics (water pills).

Even if a medication may be causing your symptoms, don’t stop taking it without talking to your doctor first.

What Can Help With Eye Twitching?

Finding the cause of your eye twitching can help you choose the best treatment. Looking for patterns in when your eye twitches, such as when you haven’t had enough sleep or are under a lot of stress, can help.

Tips To Try at Home

If you can figure out specific triggers for your eye twitching, making changes to your life can help reduce how often you get eye twitches. This can mean trying to get more sleep, reducing alcohol or caffeine intake, managing stress, avoiding smoking, taking breaks from eye-straining activities, reducing the brightness of lights, or using eye drops to avoid dry eyes.

Members of MyMSTeam also offer solutions that have worked for them:

“I usually rub the area for a little bit with my finger, and it usually goes away.”

“It helps to put a cold pack on it for a few minutes.”

“Muscle spasms can sometimes be alleviated through magnesium supplementation.”

“Try eating a banana. Low potassium can cause random twitching like that.”

Although no solution works for everyone, it might be worth trying a few of these at-home tricks to see what works for you.

Medical Treatments

Aside from at-home treatments, some specific medications and treatments can help with eye twitching. One common treatment is a botulinum toxin injection that works by relaxing the muscles that are spasming.

Other medications used to treat eye twitches are steroids (if it’s connected to an MS relapse), muscle relaxants, anti-seizure medications, and other medications to reduce abnormal muscle activity. As mentioned above, certain anti-seizure medications can cause eye twitching. It may take some trial and error to find the medication and dose that work best for you.

Because eye twitching can be a symptom of MS, it’s important to make sure your MS treatment plan is working well. There is no current cure for MS. Treatment is focused on lowering the number of relapses and easing symptoms.

When Should You Talk to Your Doctor?

It’s always a good idea to stay in touch with your medical team, especially when you have an ongoing health condition like MS.

Signs It’s Time To Seek Medical Advice

When it comes to eye twitching, it’s a good idea to book an appointment if your symptoms are getting worse, not resolving, or causing other symptoms like redness and swelling in your eyes. If you’re not sure, it’s best to see a doctor.

Why Getting Evaluated Matters

Your healthcare team can help figure out what’s causing your eye twitching. Your neurologist can look at your symptoms and help build the best treatment plan for you.

Staying on top of your care and updating your treatment when needed can help you feel your best.

Join the Conversation

On MyMSTeam, people share their experiences with multiple sclerosis, get advice, and find support from others who understand.

Have you had eye twitching as a symptom of MS? Let others know in the comments below.