Dear patient,

The condition that you mention is suggestive of blepharospasm, actually a benign "twitching" of the smooth muscle of the eyelids, which tends to happen during stress, sleep deprivation or after straining vision for prolonged periods of time; usually it is not a sign of systemic hypertension. Since it is a rhythmic involuntary contraction it looks pulsatile.

Hope this helps, best regards,

Dr Brenes-Salazar MD
Mayo Clinic Rochester

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Sorry about the confusion, now you made it clear that it is a vascular pulsation. Most of the time, this corresponds to the pulsation of the retinal arteries in the back of your eye bulb (which is the reason why it is synchronous with your other peripheral arterial pulses). It can happen with increased systemic blood pressure as you mention. It would not be worrisome if it only happens in such conditions as you mention (eg. stress or high altitude) which are known to increase blood pressure. Nevertheless, the following things need to be ruled out to make sure that it is a benign phenomenon:

1) Make sure you don't suffer from chronic high blood pressure
2) Make sure that your intraocular pressure is normal
3) Make sure that your retinal fundoscopic exam is normal

The first one can be most accurately achieved by an ambulatory blood pressure monitor (alternatively, a log of blood pressures over 2 weeks). #2 and #3 you need to see an ophtalmologist who can perform these tests.

Hope (that now) this is useful! Wish you the best,

Dr Brenes-Salazar MD
Mayo Clinic MN

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