We are used to eye twitches caused by fatigue, stress or too much screen use. But what if the contractions around the eyes indicate a more serious problem? Ophthalmology Specialist Assoc. Prof. Dr Ayşe Burcu Dirim warned about the dangers behind this problem that we do not dwell on.

Eye twitching is one of the body reactions that occur suddenly during the day and can sometimes reach annoying dimensions. Although this discomfort is not considered a serious problem for many of us, experts warn that it may be an indicator of a serious health problem. So much so that many of us do not think that this is a problem with the eye muscles or that it may be caused by intense stress. There are several reasons why eyelid twitching can occur. If only one eyelid is twitching, this is usually what we call a muscle twitch, which is quite normal, temporary and typically resolves on its own. However, in some cases it can be a little more difficult to find the underlying problem. Ophthalmology Specialist Assoc. Prof. Dr Ayşe Burcu Dirim explained the causes and possible risks of eye twitching.

EYE MUSCLES MAY BE AFFECTED İN ELECTROLYTE İMBALANCE

These contractions in the orbicularis muscle surrounding our eyes, called ‘myokymia’ in medicine, are popularly called twitching. The severity of these twitches, which occur as a result of temporary cramps in the muscles around the eyes, varies depending on the amount of muscle fibres involved. One of the most common causes of eye twitching may increase as a result of fatigue, insomnia and stress tiring the muscle fibres. Eye muscles that work very actively are quickly affected by fluid and electrolyte imbalance and such temporary contractions occur. Sometimes dryness, infection, allergy conditions can also cause eye twitching.

WE SHOULD AVOİD COFFEE AND STRESS

Reminding that eyelid twitching is usually a benign and spontaneous condition, Assoc. Prof. Dr. Ayşe Burcu Dirim said, “Increasing fluid intake, mineral water consumption to balance electrolyte loss, caffeine restriction, regular sleep, and reducing stress will quickly improve eye twitching. The use of sunglasses in people who are sensitive to light, intermittent resting of the eyes in people who use computers intensively will also contribute to the process. An underlying neurological or eye-related condition should be investigated in twitching that persists continuously and exceeds one week.”

A METHOD TO REDUCE THE DİSEASE HAS NOT YET BEEN DEVELOPED

Stating that blepharospasm is divided into two as ‘benign’ and ‘malignant’, Assoc. Prof. Dr. Ayşe Burcu Dirim states that the difference between them can be detected by Magnetic Resonance (MR) imaging method. Asked how benign and malignant blepharospasm is detected, Assoc. Prof. Dr. Dirim stated the following: In order to distinguish benign (essential, benign) or malignant blepharospasm, it should be checked whether there is a pathology originating from the brain with MR imaging method. Blepharospasm may be the first symptom of underlying Parkinson’s disease. Blepharospasm may also be a symptom of lesions in some parts of the brain. Blepharospasm usually occurs over the age of 50 and without an underlying disease and causes severe contractions in both lids. Although their severity varies according to stress and anxiety, they disappear completely during night sleep. In recent years, we have been trying to reduce the severity of contractions by using filtered lenses that block the light to which the person is sensitive in order to regulate visual stimuli. Although promising results have been obtained in some patients, a method that effectively reduces the disease has not yet been developed.

MAY BE A SYMPTOM OF PARKİNSON’S DİSEASE

A persistent twitching that lasts for more than two weeks, a visible change or pain around the eyes indicates that there is a serious problem underlying this problem. This can be seen as problems that can lead to muscle stiffness and tension, affecting movements and facial expressions. It may be an indicator of a problem in the brain or an early sign of Parkinson’s disease. In the event of such a situation, early diagnosis is very critical. Blepharospasm may be the first symptom of underlying Parkinson’s disease or blepharospasm may be a symptom of lesions in some parts of the brain. Benign and malignant blepharospasm can be differentiated by neurological examination and eye examination. For this reason, it is very important to consult a specialist doctor on time for early diagnosis.

20+20+20 RULE

First of all, those who use the computer screen too much should follow the rule of working for 20 minutes, taking a 20-second break and resting by walking 20 metres. Those working in front of the screen should not forget to blink frequently. The simplest method to get into the habit of blinking when you are at the computer is to close one page and open the other. Fatigue is a more serious factor than it is thought to be. In such cases, ensuring sleep patterns and resting your eyes while you are at home can be effective in solving the problem. In advanced cases, experts recommend using botox (botulinum toxin) injections to weaken the spasming muscles or surgical intervention to the orbicularis muscle that causes the eyelid to twitch. Since blepharospasm is a chronic condition and it is not possible to spontaneously improve or eliminate it with a single treatment, it is very important to stick to the treatment recommended by your doctor for quality vision.

March 2024

If you experience problems such as burning, redness or yellowing of your eyes, you might think that the problem occurs because of your eyes.

White or yellow swelling
If you have white or yellow bumps on your eyelids or around your nose, you may have high cholesterol. If you have these symptoms, you may want to check your cholesterol.
Yellow eyes
If the whites of your eyes turn yellow, you may have high levels of bilirubin in your blood. Yellow eyes can be a sign of jaundice, but can also indicate a liver infection, gallstones or cancer.
Light colored eye veins
When you pull down your lower eyelid, you should see a red or pink vein. If your blood values are low, you may be suffering from anemia. Anemia, which is more common in women than in men, is caused by iron deficiency.
Impaired vision
If you find that some parts of your vision are missing, you may be at risk of a stroke. The part of your brain involved in vision will be affected during a stroke.
Blurred eye
Eyes that look like they are popping out may be a sign of an overactive thyroid. One in 3 people with overactive thyroid glands experience eye problems.

November 2023

Blepharitis is a very common condition. It causes symptoms such as red eyelash bottoms and burning and stinging that disrupt patient comfort.

Inflammation of the base of the eyelashes is very difficult to treat. It is a chronic condition. Although it is not possible to cure it completely, it calms down with regular treatment and symptoms decrease. The area we call the base of the eyelash is the edge of the eyelid. In this area, the skin in front and the conjunctiva mucosa from behind meet. Eyelashes come out from here. There are also meibomian glands with pores in this area. The oil secreted by these glands lubricates the surface of the eye and slows the evaporation of tears. Inflammation of the base of the eyelashes is a common name for problems in this area. In addition, microscopic parasites called demodex that live in this area are the creatures that increase this inflammation.

There are several types of eyelash base inflammation. There are seborrheic form, which is characterized by dandruff and eyelash loss, and there are also types in which the meibomian glands located inside the eyelids do not work well, that is, the secretion of the oil layer of the tear is impaired. These conditions, which are referred to as inflammation of the root of the eyelashes, may give different symptoms. What they usually have in common is the prevention of adequate wetting of the surface of the eye and the occurrence of dry eye due to inflammation of the eyelashes.

What are the symptoms of eyelash base inflammation?
Symptoms of inflammation of the base of the eyelashes include burning due to dry eyes,

• Sting
• The feeling of sand escaping,
• Watering of eyes
• Eye redness,
• Eye tearing may include

In addition, pain in the eyes, swelling of the lids, fullness of the lids, redness, dandruff at the base of the eyelashes, itching at the base of the eyelashes, eyelash loss, whitening of the eyelashes can be counted due to inflammation of the eyelash base. Especially meibomian gland dysfunction, in which the meibomian glands do not work well, is the main cause of burning, stinging, watering and eye fatigue experienced by young people and computer workers.

The secretion of these glands is very important in terms of dry eye, because in the case of inflammation of the base of the eyelashes, the ends of these glands are blocked and when the secretions and secretions are not sufficient, the tear evaporates rapidly and the eye surface dries and also loses lubrication. Also, the lids that do not slide on the dry surface irritate the eye surface and increase the complaints of burning, stinging and watering. The comfort of our eyes depends on the adequate and proper secretion of the secretions of these glands on the eye surface. While the blockages at the ends of these glands simply increase the complaints of dry eye and cause burning, stinging and watering, fully blocked sebaceous glands cause stye, that is, chalazion.

If the ends of these glands, of which there are 20 in the lower lid and 40 in the upper lid, are blocked and destroyed over the years, very serious complaints of dry eye occur at an advanced age.

Eyelash base inflammation treatment?
In order for our eyes to be healthy and comfortable, it is necessary that the area around the base of the eyelashes is clean and healthy. Although the causes may be different, basically similar treatments are applied for all inflammations of the base of the eyelashes and meibomian gland problems. Although cortisone eye drops provide temporary relief, they have little place in the actual treatment, do not provide permanent treatment and have very serious side effects. The treatment of the inflammation of the base of the eyelashes is based on opening the meibomian gland mouths and cleaning the base of the eyelashes, in addition to controlling the demodex parasite, if any. To rid the base of the eyelashes of inflammation, they need to be cared for in the same way as we brush our teeth, because it is not possible to clean their tips very well when we wash our face. Here is what needs to be done to keep the meibomian glands working properly and to prevent inflammation of the base of the eyelashes.

They will be used for inflammation of the base of the eyelashes and meibomian gland dysfunction;

• Heat application – warming the lids and softening the oil secretion,
• Mechanical pressure – removing softened oils from the rag orifices by pressure,
• Mechanical cleaning – to remove dry oil plugs and dandruff,
• Chemical cleaning – to kill the demodex parasite,
• Lubricating the surface of the eye – tear drops.

First of all, in order for the secretions of the meibomian glands to reach the base of the eyelashes, their ends must be open, the oil secretion coming to this area dries up due to various metabolic and external influences and plugs are formed.

Prof. Dr. Ahmet Akman

Eye Health and Diseases Specialist

October 2023