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7 Tips for Your Next Eye Exam
The eye holds a unique place in medicine. Your eye doctor can see almost every part of your eye from an exterior view. Other t...

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Have you ever felt a twitching sensation in your eye? Were you sure everyone was looking at you because of it? Worried it is the beginning of a big problem?

Relax, it’s not likely to be a big deal. Most of the time it is not even visible to other people.

First, it’s almost never your actual eyeball that is twitching; it’s your eyelid muscle. The actual eye twitching is fairly rare and would cause the vision to be fairly blurry if the eyeball was really twitching.

The eyelid has a muscle in it that closes the eyelid and that muscle has a very high concentration of nerve innervation. Because of that dense nerve tissue in the eyelid, anything that makes your nervous system a little hyped up or off kilter can result in the eyelid twitching.

What are some of the risk factors for eyelid twitching?

Fatigue

Not getting enough sleep can result in your nervous system not performing at its best and one of the results of that may include twitching of your eyelid. If you are getting frequent eyelid twitching, try to make sure you are getting the proper amount of sleep.

Caffeine

Too much caffeine can certainly overexcite your nervous system and result in frequent eyelid twitching. If eyelid twitching is becoming something you experience frequently it might be time to cut down your caffeine intake. While coffee tends to be the biggest offender, caffeine does come in other flavors. Tea, cola soda and chocolate are the easy ones that come immediately to mind. Other items that you don’t think of as much: ice cream (especially chocolate or coffee flavors), de-caffeinated coffee (still has some caffeine), power or energy bars, non-cola soft drinks (Mountain Dew, Dr. Pepper, some root beers) and some OTC pain relievers (Excedrin Migraine, Midol Complete, and Anacin).

Stress

This is a hard one to quantify but if I ask most people who come to me with a complaint of eyelid twitching if they are under more stress than usual the answer is almost always, YES. This is not an easy thing to mitigate. You may need to seek some help from your internist or psychiatrist or you could just try some home remedies like meditation or Yoga.

Dry Eyes

One of the first things I tell people suffering from eyelid twitching is to use a lubrication drop in their eye. Anything that irritates your eye may result in eyelid twitching and an OTC lubricating drop in the eye may just decrease the eyelid twitching and it is certainly worth a try.

What if it won’t go away? Could it be anything more serious?

There is a condition that could cause frequent twitching of the eyelid that is more than just a slight annoyance and that condition is called essential blepharospasm. In this condition you don’t just feel the lid twitching, but the entire eye starts closing involuntarily like you are trying to wink at someone. This can start to interfere with your normal daily life and can make things like driving and reading difficult to do. If the lid closing gets that significant, the main treatment for it is Botox injection to weaken the muscle that closes the eyelids. This stops the lid twitching very effectively, but it often needs to be repeated every 3 or 4 months.

Most of the time eyelid twitching just goes away on its own as mysteriously as it came. If you experience twitching that doesn’t go away try making some of the modifications I mention above and if that doesn’t work you should schedule an exam.

Article contributed by Dr. Brian Wnorowski, M.D.

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Ask Dr. Stewart Your Eye Care Questions

What can be expected during a contact lens fitting?

A patient can expect to have a different experience when having a contact lens fitting. In addition to the eyeglass exam, questions will be asked to determine which contact lens will work best for them. Will they want to leave the lenses in their eyes overnight or will they remove them every day? Will they wear them only occasionally or will they be for everyday use? Do they want a contact lens that they throw away every day or do they want a contact lens that they have to clean and disinfect? If the patient is over age 40 and has a compromised ability to see up close, how will they see up close with their contact lenses? Will they wear readers over their distant contacts, or will they wear multifocal contacts, or will they wear monovision?

Are some people more prone to having Dry Eyes than others?

Experiencing dry eye symptoms is more common as we grow older, particularly in people 50 years of age and older. Hormonal changes in women who are experiencing menopause or who are post-menopausal. Inflammation in our body can affect the tear gland's ability to produce tears. Eye or health conditions such as glaucoma, diabetes, lupus, rheumatoid arthritis, and Sjogren's Syndrome can be associated with Dry Eyes. Environmental conditions such as dry winter air, dry indoor heated air, working on the computer, and wearing contact lenses can cause Dry Eyes.

Are there advantages to single-use contact lenses? What are they?

Single-use daily wear contacts are convenient to the patient and a healthy recommendation from their eye doctor. At the end of the day, the patient only has to dispose of the contacts. There is no need to take the contacts out to clean and disinfect them. The patients time and money spent on solutions and caring for them are eliminated. Not to mention that the next time they wear a contact, they will be wearing a brand new contact! The single best recommendation your eye doctor can make is to recommend single-use daily wear contacts. They are the healthiest contact that can be worn. The contact lens pathology issues of wearing the same contact for two or four weeks such as neovascularization, microcystic edema, and bacterial infections are greatly reduced.

What is an eye infection?

Your eyes can get infections from bacteria, fungi, or viruses. Eye infections can occur in different parts of the eye and can affect just one eye or both. Two common eye infections are conjunctivitis (also known as pink eye) and lid styes which are swollen lid bumps that can also be painful. Common signs of an eye infection are pain, itching, or a sensation of a foreign body in the eye, photosensitivity, redness or small red lines in the white of the eye, discharge of yellow pus that may be crusty upon awaking, and tears.

What happens during a typical Diabetic Eye Exam?

Your Eye Doctor will evaluate the back of your eye called the Retina to check for leaking blood vessels. Diabetic retinopathy occurs when elevated blood sugars damage the walls of the blood vessels. The vessel walls may thicken, leak, develop clots, close off, or grow balloon-like defects called microaneurysms.

My eyes tear all the time. Why do you call it Dry Eyes?

Your eyes have extra tears because your eyes produce extra tears to combat irritation and dryness. A better way to describe Dry Eyes is tear film instability, which refers to the composition of your tears not being in the proper composition. Stopping eyes from producing extra tears is a goal in the treatment of Dry Eyes.

At what age should my child have his/her eyes examined?

If you ask 10 different Doctors you will get 10 different answers. Newborns have their eyes checked in the birthing ward for starters. From birth to age 5 their eyes are growing. At age 5 is a good time to schedule a regular eye examination, however, if any unusual eye behavior is observed under age 5 an eye exam should be scheduled at that time. Unusual eye behavior such as eye squinting, a head tilt, or having to get close to see.