If you have persistent eyelid myokymia, is it okay to get botox or even have surgery?

Botox!: Botox is a heaven sent for many patients. Surgery has not been shown to be effective when compared to botox.

Yes and no: What you describe is defined as eyelid twitching. If it is more extensive it can be blepharospasm and then the answer is or might be yes. These signs/symptoms can be from medications, stress, localized untreated eye disease or be a manifestation of facial problems like sinus or even bad teeth. See an ophthalmologist first.

Possibly: An accurate diagnosis before treatment is essential for success. See an ophthalmologist (preferrably a neurophthalmologist), as well as a neurologist if there are any associated symptoms. Botox may be very appropriate in some cases but as with all treatments there are potential risks (droopy eyelid, slow blink, etc).