Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.
1
Is any of this happening now?
Call 911
Call emergency services for sudden facial drooping or weakness, especially with arm weakness, trouble speaking, confusion, severe headache, or difficulty walking.
Other emergency signs, for anyone
Someone who is struggling to breathe, gasping, choking, or cannot get words out
Someone who has chest pain, tightness or pressure lasting more than a few minutes
Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
Someone who is unconscious, or cannot be woken
Someone who is bleeding heavily and it will not stop with firm pressure
Someone who has had a seizure that will not stop, or does not wake up afterwards
Someone who has lips or skin that look pale, blue, grey or blotchy
Someone who you believe has taken an overdose or swallowed something poisonous
2
Is any of this happening?
Be seen today
Seek same-day medical care for a painful, very red eye, marked light sensitivity, or a new change in vision.
A new drooping eyelid or double vision also needs prompt assessment.
These are not features of an ordinary eyelid twitch and can be signs of a stroke or another urgent neurological problem.
3
Does any of this apply?
Book an appointment
Book a routine appointment with a doctor or eye-care professional if the twitch:
Continues for several weeks
Happens often enough to disrupt reading, driving, sleep, or work
Causes the eye to close completely
Spreads to the cheek, mouth, or another part of the body
Affects both eyes with repeated forceful blinking
Comes with ongoing redness, swelling, discharge, or eyelid irritation
Began after starting or changing a medicine
Every sign above is quoted from the sofidex article on Eyelid twitch. If you are not sure, err upward — it is always reasonable to be checked.