Why does my eye twitch and my vision blur by evening?

Frequent eye twitching is mostly linked to stress, tiredness, and caffeine or alcohol. It is rarely serious and usually stops on its own within a few days or weeks. Blurry vision in the evening usually comes from a day of close-up focusing and blinking less, which dries the surface of the eye. Both tend to ease with eye breaks, enough sleep and less caffeine, but see a doctor if a twitch lasts more than 2 weeks or your vision blurs suddenly.

Why does my eye keep twitching?

An eye twitch is when your upper or lower eyelid moves in short, repeated flickers that you cannot control. Sometimes it lasts a few seconds; sometimes it comes and goes all day. The UK's NHS says twitches are common, most people get them from time to time, and they are very rarely a sign of anything serious. Twitches can affect any part of the body, but the eyes and legs are particularly common.

What it is usually linked to

According to the NHS, twitches are often linked to:

• Stress and anxiety, such as deadlines, exams or a lot on your mind
• Tiredness and exhaustion, such as several late nights in a row or long stretches of work without a break
• Caffeine and alcohol, such as several cups of coffee, tea or energy drinks a day
• Some medicines — check the side effects listed on the packet or leaflet

Why busy weeks bring it on

These factors tend to arrive together. In a busy stretch we sleep less, feel more stressed and drink more coffee to stay alert, so it is no surprise when a twitch shows up at the same time. The NHS notes that some people also feel tingling or cramps in the same area.

Is eye twitching a sign I'm missing a nutrient?

Many people ask this, but none of the public health sources used in this article name a nutrient deficiency as a cause of eye twitching. What the NHS lists as common links is stress, tiredness, caffeine or alcohol, and some medicines. So it cannot be said that a twitch is your body telling you it lacks a particular nutrient.

What to check first

Instead of looking for one nutrient, review these three things:

1. Sleep. How many hours a night did you sleep last week? The US CDC recommends 7 hours or more for adults aged 18 to 60.
2. Stress. Is something putting you under ongoing pressure?
3. Drinks. How much coffee, tea, energy drinks or alcohol do you have in a day?

If the twitch does not go away, a doctor can help find the cause. The NHS says a GP may check for causes such as stress or a medicine you take, ask you to come back if it has not stopped in a few weeks, or refer you to a specialist in the nervous system (a neurologist) for tests.

What can I do about an eye twitch?

The NHS says a twitch may come and go but will normally stop in a few days or weeks, and there is not usually any treatment for it. Here is what you can do yourself.

Do

• Get plenty of rest and aim for the recommended hours of sleep
• Find ways to relax that suit you, such as a walk, stretching or slow breathing
• Try not to worry about it — the NHS says a twitch is usually harmless and worrying can make it worse

Avoid

• Drinking lots of caffeine, such as tea and coffee
• Drinking lots of alcohol
• Stopping a prescribed medicine on your own, even if you think it could be the cause — talk to a doctor or pharmacist first

Why does my vision get blurry in the evening?

Blurry, tired, stinging eyes or trouble focusing by evening are usually the sum of a whole day of eye use. healthdirect, the Australian government's health information service, explains that eye strain happens when you concentrate on something for a long time. It says eye strain is not a disease and usually goes away when you rest your eyes.

Eye muscles tire from close-up work

When you look at a screen or a page up close for a long time, your eye muscles work hard, and like other muscles in the body they tire if they do not get a chance to rest. healthdirect notes that after a long time on near tasks you may find it harder to refocus on far-away objects. That is why a sign across the street or the TV can look soft when you finally look up from your screen in the evening.

Blinking less dries the eye surface

The American Academy of Ophthalmology (AAO) says people normally blink about 15 times a minute, but studies show we blink only about 5 to 7 times a minute while using computers and other digital screens. Blinking is how the eye keeps its surface moist, so after a day of blinking less the surface dries and your eyes feel tired. Air conditioning, fans blowing at your face and smoking can also dry the eyes.

Lighting and glasses

healthdirect lists other common causes: straining to see in poor light, not wearing glasses or contact lenses you need, or wearing ones that are no longer right for you. If your glasses do not seem to help as much as they used to, get your eyes checked.

Signs that often come together

Besides blurring, you may have tired, sore or itchy eyes, watery or dry eyes, and a sore neck, shoulders or back from muscle tension. If these show up on days of long screen time or reading and ease when you rest, that fits with eye strain.

What can I do about blurry eyes in the evening?

healthdirect says the best thing for eye strain is rest, which usually eases the discomfort, at least in the short term. These habits help keep eye strain away.

Use the 20-20-20 rule

Every 20 minutes, look at something about 20 feet (around 6 metres) away for 20 seconds. If you tend to forget, set an alarm. Spending time outside regularly and looking into the distance also lets your eye muscles relax.

Blink on purpose

The AAO suggests making a conscious effort to blink often so the surface of your eyes does not dry out. Some people stick a note on the edge of their screen as a reminder. If your eyes often feel dry, a pharmacist or doctor can advise you.

Fix the light and the airflow

• When reading or doing close work, place the light behind you so it shines directly on what you are doing
• Turn down air conditioning or fans blowing at your face, or use a humidifier in a dry room
• If you smoke, know that smoking can dry your eyes

Adjust your screen

Screen brightness, contrast, text size, distance and height all play a part. The details are in How should you use your eyes on a long screen day?

Sleep enough

Getting plenty of rest is the first thing the NHS suggests for a twitch, and rest is also what healthdirect recommends for eye strain. The CDC recommends that adults aged 18 to 60 sleep 7 hours or more, those aged 61 to 64 sleep 7 to 9 hours, and those 65 and older sleep 7 to 8 hours.

When should I see a doctor about eye twitching or blurry vision?

Most of these symptoms ease with rest, but some situations should not wait.

Eye twitching

The NHS advises seeing a doctor if:

• You have a twitch for more than 2 weeks
• You have a twitch in more than one place
• The affected area feels weak or stiff
• You think a prescribed medicine might be causing your twitch

Blurry vision

• If your symptoms do not improve after resting your eyes, or get worse, see a doctor or optometrist. healthdirect notes that some serious conditions can cause symptoms like eye strain.
• If blurring keeps coming back or your vision changes, get checked by a doctor, optometrist or ophthalmologist.
• The AAO advises seeing an ophthalmologist if your eyes are consistently red, blurry or watery, or become sensitive to light or painful.
• healthdirect suggests an eye check every 2 years for people without eye problems.

Go straight away

• If your vision suddenly blurs or you suddenly lose vision, get medical help right away.
• If sudden blurring comes with dizziness, weakness or numbness on one side of the body, a drooping face, loss of balance or slurred speech, it may be an emergency — call an ambulance immediately.