Eye twitching (not severe enough for whole lid to close) persistent for months (on and off multiple times a day) causes? / should seek medical exam?

Lid myokymia: This type of twitching is often called lid myokymia and is often due to dry eyes (tears do not stay on eye as they should & cause a perceived sense of dryness of eye; meibomian glands may be clogged for instance), stress, caffeine intake, lack of sleep. See your eyemd to rule out other causes that are much less common.

Myokymia: Random twitching of an eyelid, which happens in normal people, is called myokymia (an involuntary, spontaneous, quivering of a few muscle cell bundles within a muscle). Myokymia starts and stops spontaneously. In the eyelids, it can last a few minutes to a few days. It can be caused by stress, dry eyes, lack of sleep.