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The question

I have had a twitch in the same spot of my left eye (on and off) for at least 6 months. I have spoken to my eye doctor about it and she said it's probably due to stress. I honestly don't feel overly stressed at the moment - I've been under worse stress in the past without any eye issues.

The answer

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Most eye twitches are involuntary, harmless spasms of the small muscles surrounding the eye. The most common triggers are squinting, stress, fatigue, and excess intake of caffeine and alcohol. Another increasingly common trigger is eye strain, related to long periods of time in front of the computer, working in low light settings or due to a wrong prescription if you wear contact lenses or glasses.

Certain medications, especially those used to treat epilepsy or mental health conditions, can also trigger muscle spasms.

While it seems you are managing your stress well, it may still be insidiously presenting itself with this eye twitch. Lack of sleep is another common trigger, so in addition to stress reduction, monitor your sleep patterns and get proper rest to see if that helps.

You've already taken the right steps by seeing your eye doctor. For eye twitches, especially given the duration of 6 months, I suggest having a full eye examination to rule out an underlying eye condition or vision loss that needs to be corrected. Other potential eye concerns that may trigger twitch are dry eyes. If your eyes feel gritty and you have to blink repetitively to lubricate the eyes well, this can stress the muscles and lead to an occasional twitch.

The eyes can dry out due to poor hydration and prolonged periods of time in front of the computer, so frequent 'eye breaks' may be helpful to prevent the eyes from drying out. If dry eyes is a concern, a trial of artificial tears after consulting with your doctor may be helpful.

If you've noticed an increase in your consumption of caffeine (teas/coffees/soft drinks) or alcohol over the past few months, cutting back to see if it helps with the twitch may be beneficial.

Like any other muscle in the body, spasms of the muscles around the eyes can occur when they're overworked, tired or stressed in some way. Keep a diary of your symptoms, identify potential triggers and see if reducing exposure to them will help alleviate the twitch.

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If despite making these changes, your symptoms become persistent or you have any concerning symptoms such as pain, blurred vision or any other neurologic symptoms such as twitch or weakness in other parts of your body – I would recommend visiting your doctor as another referral back to your eye doctor or in some cases, to a neurologist, may be warranted.

Send family doctor Sheila Wijayasinghe your questions at doctor@globeandmail.com. She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

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The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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