Eye Twitching When Equalizing

[Diver0823]

Just finished a dive in Jamaica today. Straightforward dive, 50 feet maximum depth. But I noticed that every time I equalized my ears (Valsalva maneuver) my right eye twitched. I didn't seem to interfere with my ability to equalize, and no other issue with my eye (no pain and could see fine). But it seemed very odd to have my eye twitch when I equalized. No other issues at depth and no issue on ascent. I believe I noticed it once before a year or so ago when equalizing upon descent in a plane. But this issue has never come up before in 80+ dives. Any thoughts? Thanks in advance.

 

[Scuba Client]

Maybe you were under stress. Maybe your mask is too tight. Maybe you were tired.

 

[Doctorfish]

I can think of a couple of possibilities
1) Hyperventillating and lowering CO2 which increases neuromuscular irritabiity. Did you have any tingling around your mouth or fingertips?
2) Too much coffee

 

[GJC]

Low calcium can cause a facial muscle twitch.

Too much caffiene?

 

[Duke Dive Medicine]

@Diver0823 that's really interesting. Did you notice any visual changes along with the eye twitching? I'm asking because there are documented cases of a bony dehiscence (part of the bone is congenitally missing) in the sphenoid sinus causing visual changes with changes in sinus pressure. One of the nerves that controls eye movement, the abducens nerve (cranial nerve III), is between the optic nerve and the sphenoid sinus so it could conceivably be affected by the same phenomenon.

Best regards,
DDM

 

[Diver0823]

@Diver0823 that's really interesting. Did you notice any visual changes along with the eye twitching? I'm asking because there are documented cases of a bony dehiscence (part of the bone is congenitally missing) in the sphenoid sinus causing visual changes with changes in sinus pressure. One of the nerves that controls eye movement, the abducens nerve (cranial nerve III), is between the optic nerve and the sphenoid sinus so it could conceivably be affected by the same phenomenon.

Best regards,
DDM

Definitely no visual changes. However, after the dive (and after my initial report above), I tried to equalize again and I observed that air is shooting out of the corner of my right eye (presumably my tear duct) when I equalize. That must be the reason for the eye twitch when I equalized during the dive. I searched this forum and found a few prior instances of divers reporting this. Interestingly, although I didn't think I had any issues with my eyes despite this phenomenon during the dive and my ears felt fine after the dive, I woke up the next morning with a full-feeling ear on that side and slightly diminished hearing (which 2 days later is now mostly recovered), so perhaps the air leaking into my eye interfered with my normal equalization.

Another interesting thing is I've been diving since 2013 and am at about 90+ dives, and this is the first time this has occurred. I did suffer a minor fracture to the orbital floor in this eye growing up (baseball to the face) about 30 years ago, but, if that were connected, it seems odd that it would not show up until now.

Back in the States today and will book an appointment with an ENT. I may need to learn and practice some different equalization techniques.

 

[Ghost95]

I have, on occasion, felt my eye "twitch" or "buzzing" if I have had to blow harder than normal when clearing my ears or blowing my nose with a cold. The twitch was actually bubbles coming out of my eye. I know weird right? But I'm not the only one that has bubbled through their eyes when blowing their nose or clearing with extra pressure I have met others and witnessed someone blow bubbles from their eyes on command. Not sure what causes it but it didn't seem to affect anything. I asked a while back about it and was told that there is a way for air from your sinus to reach your eye.

Maybe equalizing more often and earlier will limit the amount of force you need and stop the twitching or whatever it is.

 

[happy-diver]

Girls in close proximity to that eye diving in bikinis?

 

[Ghost95]

Ok, found a little more info. There's a canal called the nasolacrimal duct that runs from the corner of each eye to the nasal cavity. Apparently there is a one way valve that keeps air from coming out your eye. Sometimes due to infection or over pressuring during a Valsalva maneuver you can force air by this valve and fizz out your eye. For me it feels like a fizz / vibration / tickle. Some may describe that as a twitch.

I am not a doctor nor did I stay at a Holiday Inn Express so take this info with a grain of salt.