Why do eyes twitch while sneezing? (+3 factors)

In this article, we will discuss the reason behind eye twitching while sneezing. We will also discuss the possible remedies to reduce eye twitching.

Why do eyes twitch while sneezing?

Eye twitching while sneezing may occur due to involuntary activation of the trigeminal nerve present in the ophthalmic region. Before sneezing, the trigeminal nerve sends signals from the eyes, nose, throat, and mucosal lining of the mouth to the central nervous system to initiate a sneeze.

As a result, your brain cells send signals for the contraction of the chest and compression of your lungs which produces a blast of air which may also cause contraction and twitching of eye muscles to compensate for the force.

While eye closure happens every time, eye twitching while sneezing occurs due to spasms in the seventh cranial facial nerve that is present in the brainstem.

Eye twitching can also cause uncontrollable blinking of the eyelid muscle during and after sneezing. Sometimes the twitching is barely noticeable. However, in extreme situations, the twitching might cause the eyelids to close for several minutes.

Eye twitching may also happen due to an irritant that affects the surface of the eye, or the membrane that also triggers sneezing. Eyelid twitch may occur for a few minutes or persist for a longer time if the underlying cause is not treated.

How does sneezing cause eye twitching?

The sneezing reflex comprises two phases:

• Sensory phase, and 
• Respiratory phase

The sneeze itself is a respiratory phase, but it is triggered by the sensory phase. In the sensory phase, a particle or an irritant is detected in the mucus lining of the nose. This causes activation of the trigeminal nerve due to the release of histamines or leukotrienes.

The trigeminal nerve then stimulates the medulla oblongata that is present in the brainstem. The optic nerve is also connected to the trigeminal nerve. This activates the respiratory phase. The medulla oblongata triggers the parasympathetic system.

Tearing of the eyes, eye closure, diaphragm contraction, and stimulation of breathing muscles help the person take a deep breath. This increases the lung pressure, allowing the glottis to open and release a gush of air into the throat that travels to the nose as a sneeze.

Simultaneously, the body may use eye muscles to compensate for the force exerted on the muscles involved in a sneeze. This can cause ocular muscle spasms and eye twitching (1). 

What are other physiological factors behind eyes twitching while sneezing?

Some of the physiological factors that can cause eye twitching while sneezing might include:

• Fatigue and stress: People who are under continuous stress, anxiety, and depression frequently experience eye twitching while sneezing.
• Nutritional deficiency: Eye twitching and spasm is common in patients who are deficient in magnesium, Vitamin B12, and Vitamin D. 
• Sleep deficiency: Eye twitching while sneezing is common in people who do not follow a sleeping pattern.

Sleeplessness, insomnia, and not getting enough sleep can trigger eye twitching. Sleeplessness, stress, and caffeine trigger ocular myokymia (eyelid twitching). 

• Allergic reaction: Histamines released during allergic reactions can cause eye irritation.

This eye irritation can lead to eye twitching, especially while sneezing due to the allergic reaction. Rubbing the eyes due to an irritant further releases histamine in the eyelid tissues, leading to eye twitch.

• Blepharitis: It is the inflammation around the edges of the eyelid. Blepharitis can cause swelling, redness, irritation, and eye twitching.

What are the neurological factors causing eye twitching while sneezing?

Some of the neurological factors that can cause eye twitching, especially during sneezing, might include:

• Dystonia: Eye dystonia is excessive and uncontrollable eye blinking. It causes sensitivity, spasms and dry eyes. Dry eyes and spasms can further lead to eye twitching.
• Benign Essential Blepharospasm (BEB): It is a form of dystonia that causes eye twitching, repetitive movements, and spasms (2).
• Bell’s palsy: After facial paralysis, the body may attempt to fix the paralyzed area through abnormal facial nerve regeneration.

This can trigger eye twitching and eyelid drooping while smiling, eating, blinking and closing the eyes (3).

• Multiple sclerosis: Multiple sclerosis can sometimes cause myoclonus which is an involuntary twitching of the muscles.

It can sometimes cause facial twitching, especially in the eye muscles. Patients might also experience blurred vision, double vision, or other vision issues.

When to consult the opthalmologist?

The patient experiencing rapid eye twitching, especially while sneezing, should immediately consult the opthalmologist. The symptoms might include:

• Persistent twitching for one week,
• Redness, itching, and swelling of the eyes,
• Drooping of the eyelid,
• Difficulty in keeping the eyes open.

How eye twitching might be prevented?

Some triggers can also cause the occurrence of eye twitching while sneezing. Maintaining and controlling these triggers can lessen the eye twitching, including:

• Improve sleeping pattern: Improving the sleeping pattern can reduce the occurrence of eye twitching.
• Lower the depression: Take a break from the hectic environment and relax. In severe depression, antidepressants can also be prescribed by the doctor.
• Reduce eyestrain: Patients who do not control their screen time, including TV, laptops, mobile phones or gaming, are prone to eye spasms. Reducing the screen time and relaxing the eyes can reduce the chances of eye twitching.
• Treat dry eyes: If the patient wears lenses, or has a medication side effect that causes dry eyes then he might experience eye twitching while sneezing. Wearing wraparound sunglasses and eye drops can reduce such effects.
• Balanced Diet: Improving the diet and taking dietary supplements can help reduce eye twitching.
• Treat the allergy: Allergic reactions can be treated with antihistamines like ketotifen. However, careful selection of antihistamines is required as some antihistamines might cause dry eyes.

I expereince eye twitching while sneezing frequently especially when I am stressed. Although an involuntary action, eye twitching makes me uncomfortable when I am sitting in an audience. Most of the time gently pressing the eyelid relieves the twitch.

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