Avoid Your Allergy Triggers
Allergies can wreak havoc on your eyes. How? Allergens trigger a release of histamine in the body, which causes blood vessels to dilate and your eyes and nose to feel itchy ad irritated. Allergies also cause swelling, which makes your eyes look puffy and tired.
If allergies are the cause of your tired eyes, take an antihistamine, either an over-the- counter or prescription variety, to make your eyes look less puffy, red, swollen and feel less itchy.
Avoid other allergy triggers, like driving with your windows down or spending time outdoors during allergy season, to keep your eyes from looking and feeling tired.
How Hormonal Imbalance Causes Dry Eyes
Just about every structure in the eye, including those responsible for making your tears such as the lacrimal gland and the Meibomian gland are influenced by your sex hormones.
The opposing effects of estrogen and androgens on tear production appear to reverse at menopause. Specifically, estrogen now appears to inhibit tear production and testosterone enhances it. With menopause, both hormones drop, but the decline in testosterone may have a bigger effect now on your tear production.
When your eyes stay dry for too long, the result is localized, often painful, inflammation and damage to the surface of the eyeball. This immune response generates the release of various inflammatory substances that can make your eyes red, itchy and swollen. The onset of dry eyes often coincides with other symptoms in menopause, like sore joints, dry mouth and dry vaginal tissue.
Also keep in mind that the hormonal changes in perimenopause can trigger autoimmunity in susceptible women, which may include an unmasking of Sjögrens syndrome, an autoimmune condition that causes dry eyes. If your symptoms are severe, and especially if you have another autoimmune condition, such as rheumatoid arthritis or lupus, get evaluated by your doctor.
Restoring a natural balance between estrogen, progesterone and testosterone is an important, effective remedy for dry eyes, even if you rarely hear that in a conventional eye doctors office.
When To Talk To Your Doctor
Nocturnal lagophthalmos can be hard to diagnose on your own. Even if another person observes you while you sleep, very small eyelid openings may be obscured by eyelashes and go undetected.
If youre having persistent eye symptoms, particularly dry-eye that is worse in the morning, it may be helpful to see a doctor for specialized testing. If left untreated, nocturnal lagophthalmos can significantly affect your eye health and compromise sleep. Getting a proper diagnosis and tailored treatment plan will help you get the quality shut-eye you need.
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What Are Dry Eyes
The eye depends on the presence of a tear film to provide constant moisture and lubrication to maintain vision and comfort. Tears are a combination of:
- Water, for moisture
- Oils, for lubrication and to prevent evaporation of tear liquid
- Mucus, for even spreading of tears on the surface of the eye
- Antibodies and special proteins, for resistance to infection
These components are secreted by special glands located around the eye. When there is an imbalance or deficiency in this tear system, or when the tears evaporate too quickly, a person may experience dry eye.
When tears do not lubricate the eye enough, you may have the following in your eye:
- A gritty sensation, like a feeling of a foreign body or sand
- Redness and blurring of vision
Sometimes, a person with dry eyes will have excess tears running down the cheeks, which may seem confusing. This happens when the eye isn’t getting enough lubrication. The eye sends a distress signal through the nervous system for more lubrication. In response, the eye is flooded with emergency tears.
However, these tears are mostly water and do not have the lubricating qualities or the rich makeup of normal tears. They will wash dirt away from the eye, but they will not coat the eye surface properly. In addition, because these emergency tears tend to arrive too late, the eye needs to regenerate and restore itself, and treatment is necessary.
Soften Your Oil Glands
Your eyelids meibomian glands secrete oils onto the surface of the eyes in order to keep tears from evaporating too quickly. The glands are supposed to be like an olive oil consistency coming out, but some patients will get inflammation, which causes the oil to thicken to a toothpaste consistency, so it doesnt want to come out on its own, Wood says. This results in a deficient oil layer.
If you want to try to soften the oil yourself, warm a wet washcloth or compress in the microwave, then place it over your eyelids for about five minutes. EverTears from ThermaMEDx, launched earlier this year, is an over-the-counter option for those with mild dry eye symptoms. These convenient self-heating, premoistened, disposable compresses let you add warm moisture to the surface of the eye to get relief.
If that doesnt do the trick, your eye doctor may discuss different in-office procedures that squeeze, massage or otherwise treat the glands in order to release the moisture you need. LipiFlow and iLux, for instance, are devices placed over the eyelids that combine heat and pressure to soften and push out oil trapped within the meibomian glands, so the glands are able to secrete their natural oil into the tear film.
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Symptoms Of Dry Eyes With Cpap
Dry eyes are a sign that your tears arent providing sufficient lubrication for your eyes. Below are some of the symptoms of dry eyes.
- Stringing or burning eyes
- Difficulty driving at night
- The feeling that you have something in your eyes
Your CPAP may be the cause of your dry eyes, but it isnt the only possible cause. Obviously, these arent the only symptoms of dry eyes. But, if youre experiencing these symptoms, you may have dry eyes.
If you are using a CPAP machine and didnt have these symptoms before you began using your machine, the CPAP may be the cause of your dry eyes.
What Doctors Are Saying
A lot of my patients have seen great success in using a combination of scheduled in-practice treatments as well as daily, at home treatments to improve management of Dry Eye.
Dr. Jeff Goodhew
With advancing technology we now can image the damaged structures that can cause dry eye disease and recommend preventive measures to improve future eye health.
Dr. Trevor Miranda
Practicing with a focus on dry eye disease has allowed our patients to get appropriate and adequate care for a disease that has been under diagnosed for decades. Finally we have the tools and scientific support to get people the help they need to preserve their visual comfort.
Dr. Richard Maharaj
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Consult Your Eye Doctor
Many people will need to try more than one approach to treating their nighttime dry eyes. You may also need to try modifying your behavior by reducing the time you spend looking at a computer or phone screen just before bed.
Contact your eye doctor to discuss your options for alleviating your dry eye symptoms at night. Fill out our contact form or call Access Eye at to schedule your next appointment.
What Causes Dry Eyes At Night Only
Now, if your dry eye symptoms are only occurring at night, then you need to identify what could be triggering it. It could be that youre lying in a position that is causing the eyes to become dry and inflamed, such as sleeping with your face smashed into a pillow.
Another possibility would be non-organic eyelid hygiene products , because they can leave behind artificial oils or chemicals on the skin next to the tear ducts when used at night. It could also mean not drinking enough water before bedtime, or there being a lack of humidity in the air at night.
Of course, one common potential cause of chronic nighttime eye irritation that many dont think of is the possibility of an allergy or sensitivity reaction due to contact lens use. If this is the case, make sure you use hypoallergenic contact lenses and avoid wearing your contacts while sleeping.
Finally, patients may suffer from dry eyes at night simply due to a lack of sleep. In this case, be sure to practice good sleep habits, such as having a regular nighttime routine and removing any potential distractions from your room to ensure a restful nights sleep.
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Causes & Risk Factors
Dry eyes can occur when tear production and drainage are not in balance. People with dry eyes either do not produce enough tears or their tears are of a poor quality:
- Inadequate amount of tears. Tears are produced by several glands in and around the eyelids. Tear production tends to diminish with age, with various medical conditions or as a side effect of certain medicines. Environmental conditions, such as wind and dry climates, can also decrease tear volume due to increased tear evaporation. When the normal amount of tear production decreases or tears evaporate too quickly from the eyes, symptoms of dry eye can develop.
- Poor quality of tears. Tears are made up of three layers: oil, water, and mucus. Each component protects and nourishes the front surface of the eye. A smooth oil layer helps prevent evaporation of the water layer, while the mucin layer spreads the tears evenly over the surface of the eye. If the tears evaporate too quickly or do not spread evenly over the cornea due to deficiencies with any of the three tear layers, dry eye symptoms can develop.
Dry eyes can develop for many reasons, including:
Advanced dry eyes may damage the front surface of the eye and impair vision.
How To Manage Dry Eyes At Night
If you have dry eyes, the first thing you should do is schedule an appointment with your eye doctor. Theyll be able to provide an accurate diagnosis of the problem, and recommend numerous strategies for managing your symptoms.
For people whose dry eyes are particularly bad at night, eye doctors will normally recommend one of the following products or regimens:
- Lubricating eye drops: often referred to as artificial tears, these products temporarily restore moisture to your eyes.
- Ointments and gels: these products may reduce the redness and swelling that accompany dry eyes. Specific varieties are meant to be used before going to sleep, so as to reduce overnight inflammation and prevent your eyes from sticking together in your sleep.
- Sleep masks or eye seals: these devices are typically intended for people whose eyelids dont close all the way in their sleep. Masks and seals can protect your partially-open eyes from dry outside air while youre sleeping.
How Might Dry Eye Affect You
Dry eye disease is a condition that is often overlooked but can have serious short term and long term effects on those who develop it.
Short term effects include constant eye irritation, blurry vision, regularly tired eyes and difficulty in wearing contact lenses.
Dry eyes can start out as uncomfortable and annoying, but more than that it can cause permanent vision impairment if not taken care of and managed well.
Dry eyes can also impact the way you usually live your life. People may face lifestyle restrictions. Simple daily activities like reading, working and driving can become difficult.
Dry eyes can also get in the way of productivity in work and non-work related activities. Dry eyes can even impact quality of life.
Therefore diagnosing and treating dry eye disease during its early stages is essential.
What Are The Causes Of Dry Eyes
There are two leading causes of dry eyes:
rapid evaporation of tears caused by a deficiency in the oil layer
reduction of the quantity of tears produced by the glands .
Often, there is overlap between these two main causes of dry eyes.
Several factors can affect tear production or the condition of the eye in general. Dry eyes can result from many factors, including but not limited to:
White stripes on the eyelids show the Meibomian Glands in Normal vs Meibomian Gland Dysfunction .
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Seeing Your Healthcare Provider
Although dry eyes can be temporary , in some cases, the cause can be more serious and/or require medical treatment. If it’s left untreated, dry eye syndrome can lead to pain, corneal damage, and loss of vision.
Here are just some symptoms that should prompt a call to your healthcare provider:
- Eye redness and swelling
- Joint pain, stiffness, or swelling
- Blurry vision, double vision, or vision loss
- Seeing halos
- Dryness that continues after a few days
- Yellow skin and whites of the eyes
- An eye injury or infection
If you have had recent laser eye surgery, such as Lasik or photorefractive keratectomy, or PRK, you should consult your surgeon or ophthalmologist.
If you have a medical condition and are experiencing dry eye, be sure to consult your healthcare provider.
What Should I Do About Waking Up With Dry Eyes
The first step is to find out whats causing your dry eyes. The best way to get that information is to visit your eye doctor for a comprehensive eye exam.
When discussing your dry eyes with your doctor, be sure to tell them about all medications and nutritional supplements youre taking.
Depending on your specific situation, your doctor might recommend any of the following treatment options:
- Artificial tear drops. You can purchase over-the-counter eye drops that can add lubrication to your eyes. Your doctor might suggest a heavier ointment for use during sleep.
- Punctal occlusion. This is a procedure in which your doctor will close the duct that drains tears from your eyes .
- Thermal pulsation. If the glands that produce the oil in your tears are blocked and causing dry eyes, your doctor might suggest a thermal pulsation system . This system heats and massages the blockage to remove it.
Your doctor also might recommend any of the following medications:
- cholinergics, or tear-stimulating drugs, such as cevimeline or pilocarpine
- eye inserts, such as hydroxypropyl cellulose ophthalmic insert , which are inserted between your eyeball and your lower eyelid for lubrication
- antibiotics, which can reduce inflammation that might be interfering with oil-secreting glands.
- prescription eye drops, such as corticosteroids or cyclosporine , can control inflammation of your cornea
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Napping Without Being Noticed
If you dont have time to master the art of sleeping without closing your eyes, you could try to take a regular nap in public and avoid detection.
First, find a discreet place to nap, such as an office, car, closet, or bathroom. If you cant escape to a private area, sit in the back of a populated room.
You can wear sunglasses to disguise closed lids. They also have the benefit of creating darkness, which can help facilitate sleep.
Avoid slouching, and sit up straight, preferably at a table or desk if one is available. Rest your elbow on the surface and bend it 90 degrees so that your hand props up your chin. Youll look active and attentive.
Need help? Check out our complete guide on how to sleep anywhere!
Special Contacts For Dry Eyes
Recognizing the issue of dry eyes and contact lenses, doctors have created something called a scleral lens for dry eyes. These lenses have a large diameter that rests on the sclera, or the white part of the eye, over the cornea. It holds liquid between the surface of the eye and the lens to soothe the eye from dryness and any shearing that occurs due to blinking. This is a great option for those who have difficulty with conventional lenses due to dry eyes.
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What Is Eye Discharge
Eye discharge, or “sleep” in your eyes, is a combination of mucus, oil, skin cells and other debris that accumulates in the corner of your eye while you sleep. It can be wet and sticky or dry and crusty, depending on how much of the liquid in the discharge has evaporated.
Sometimes called “rheum,” eye discharge has a protective function, removing waste products and potentially harmful debris from the tear film and the front surface of your eyes.
Your eyes produce mucus throughout the day, but a continuous thin film of tears bathes your eyes when you blink, flushing out the rheum before it hardens in your eyes.
When you’re asleep and not blinking eye discharge collects and crusts in the corners of your eyes and sometimes along the lash line, hence the term “sleep” in your eyes.
Some sleep in your eyes upon waking is normal, but excessive eye discharge, especially if it’s green or yellow in color and accompanied by blurry vision, light sensitivity or eye pain, can indicate a serious eye infection or eye disease and should be promptly examined by your eye doctor.
What Causes Dry Eyes At Night
What is the reason my eyes dry more at night? There are many reasons why people suffer from dry eyes, but some of them are open at night.
The causes of recurring dry eyes are generally different. Tears are a typical main contributor to dry eyes not making enough of them, tears passed out, or tears that evaporate quickly. With each blink, the bottom of your eyelid distributes moisture to the cornea.
Without enough tears, the cornea dries out and becomes irritated.According to a report from the US National Institutes of Health, dry eyes, inflammation, and metabolic problems are also linked. The results show that adult women with metabolic problems can also develop dry eyes. There is another problem known as nocturnal lagophthalmos with dry eyes: the inability to close the eyelids while sleeping fully. This is caused by facial paralysis, deformation of the cap, or lack of healing from a medical eyelid procedure. Since the surface of the eye is exposed at night, it dries out.
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