Are you suffering from dry eyes in the morning? Find out more about the potential causes and treatments available for this common condition.
Have you woken up in the morning with uncomfortable, itchy, or burning eyes? Have you experienced redness or excessive tearing first thing in the morning? If so, you may be one of the many people affected by dry eye, a common condition that affects the eyes' ability to produce tears and retain adequate moisture.
In this blog post, we'll explore the symptoms of dry eye that are often experienced in the morning, as well as its causes and treatments. With a better understanding of dry eye, you can take steps to manage this complex condition and start your day with comfortable and healthy eyes.
What to do if you wake up having dry eyes in the morning?
Dry eye is a prevalent issue that affects many people, particularly in the morning. It occurs when your eyes do not receive enough moisture from tears, or tears evaporate too quickly, resulting in discomfort, itching, burning, redness, and excessive tearing.
Untreated dry eye can lead to severe problems like eye inflammation, infection, and damage to the front part of the eye, which may cause vision loss. However, understanding the causes and seeking proper treatment can help manage dry eye effectively.
Working closely with your healthcare provider is crucial to determine the underlying causes of your dry eye and develop a personalized treatment plan. Your provider can assess the contributing factors and recommend the best course of action for you.
It's also essential to educate yourself about dry eye to ensure successful management. Artificial tears alone may not suffice if other factors are not addressed. Taking an active role in your care and working with your provider can help manage morning dry eye symptoms and enhance your quality of life.
What are the potential underlying causes?
Dry eye in the morning can be caused by a variety of factors. Understanding the underlying factors contributing to your dry eye can help you find ways to effectively manage the condition.
Reduced tear and tear oil production during the night can be a big factor for dry eye. This happens because your body temperature and metabolism slow down when you sleep, which reduces blood flow and the amount of nutrients reaching your eyes. It results in your tear glands producing less amount of tears than during the day.
Not getting enough sleep can also lead to dry eye. Lack of sleep can change the composition of your tears, reducing their effectiveness moistening your eyes, and reducing the amount of tears your eyes make.
Dry air is a common contributing factor of dry eye, especially during the winter months when furnace heating systems are in use. The dry air not only lowers the moisture levels in the house but also may create a draft that exacerbates the evaporation of your tears, resulting in greater discomfort and dryness.
Allergies, such as seasonal allergies or reactions to substances like dust or pet hair, can cause eye inflammation and dryness in the morning, leading to dry eye symptoms.
Bacterial or viral infections can cause dry eyes by causing inflammation of the eye and damaging the meibomian glands, which reduces tear production and alters the composition of tears, making them less effective at lubricating the eyes.
Meibomian Gland Dysfunction (MGD). Your eyes are kept moist by a fluid called tear film, which is made up of three layers: water, mucus, and oil called meibum. The meibum is produced by the meibomian glands and helps prevent the water layer on the eye surface from evaporating too quickly. When there are changes to the amount or quality of the oil, or to the glands themselves, it can lead to MGD.
Asian people are three times more likely to develop MGD than people with European ancestry. Obstructive MGD is the most common type and occurs when the gland openings become clogged and less oil reaches the eye surface.
Autoimmune diseases, such as Sjogren's syndrome and rheumatoid arthritis, can also lead to dry eyes in the morning. These conditions cause inflammation and damage to the tear gland, leading to decreased tear production and symptoms of dry eye.
Blepharitis, an inflammation of the eyelids, can also cause dry eyes in the morning and may be accompanied by crusty discharge from the eyes. This condition commonly occurs when tiny oil glands near the base of the eyelashes become clogged, causing irritation and redness.
Medications play a significant role in causing dry eye syndrome. A wide range of drugs, such as antihistamines, antidepressants, anti-Parkinson's drugs, antipsychotics, antispasmodic drugs, and medications used to treat chronic conditions like high blood pressure and glaucoma, can contribute to dry eye symptoms. Additionally, antibacterial agents used before intravitreal eye injections cause dry eye.
Nocturnal lagophthalmos is a condition that occurs when you have trouble closing your eyes all the way while you sleep. This incomplete eyelid closure can lead to dry eyes in the morning. There are several factors that can cause nocturnal lagophthalmos, including trauma, infection, scarring from surgery, and diseases such as Bell's palsy.
How to manage dry eyes in the morning?
Dry eye in the morning can be a bothersome and uncomfortable issue, but there are several effective approaches available to manage this condition. The first step in treating dry eyes is to use artificial tear drops in the morning and a thicker gel or ointment at night, which may cause temporary blurriness due to its thickness. The drops serve to protect and moisturize the eyes upon waking, while gels and ointments help to alleviate more severe symptoms.
To ensure your tears stay stable, it's recommended to use artificial tears containing hyaluronic acid. It's also important to choose products that do not contain preservatives, as they may exacerbate dry eyes. Another option to help with dry eyes is to use artificial tears containing omega-3 fatty acids, which can help reduce inflammation in the eyes.
Drinking warm water before bed and getting enough sleep (7-8 hours) can help keep your eyes hydrated and well-rested.
Successful dry eye treatment involves identifying and addressing underlying causes. If your dry eyes are caused by any of the following factors, you should also consider the related management options.
Dry air at night
To manage dry eye caused by dry air at night, try these simple strategies. Apply a thicker lubricant before bed for longer-lasting relief instead of regular artificial tears. Use a humidifier in your bedroom to increase air moisture. Wear an eye mask to reduce drafts and tear evaporation, and avoid the heater vent blowing draft toward your sleeping area. And, turn down the heater can reduce drafts and maintain humidity.
Meibomian gland dysfunction
The management of meibomian gland dysfunction involves increasing tear oil production clearing the obstructions in the meibomian glands. This can be done by warm compresses or self-administered eyelid massages after waking up. If not sufficient, your doctor may recommend thermal pulsation treatment. These treatments aim to restore the natural flow of meibum, which is essential for maintaining a healthy tear film.
Nocturnal lagophthalmos
Managing dry eyes due to nocturnal lagophthalmos involves protecting the eyes at night and using viscous gel or ointment. Eye patches, masks, and special tape can help lock in moisture and keep your eyes comfortable. Eyelid weights can also be used to help people who have trouble closing their eyes due to palsy.
Using a viscous gel or ointment can help protect the surface of the eye and may also help your eyelids stick together while you sleep, which slows down tear evaporation. In severe cases, surgery may be recommended to lift and tighten the eyes or to implant devices that help close the eyelid.
Medications
If you're experiencing dry eyes due to medications, it's important to work close with your doctor. Depending on the severity of the symptoms and the medications, your doctor may suggest an alternative medication that is less likely to cause dry eye.
A more localized drug administration method may also be recommended. For example, an oral antihistamine regimen could be switched to an antihistamine nasal spray, which delivers the medication directly to the affected area and may minimize the risk of dry eye symptoms.
Underlying conditions
When experiencing dry eyes, it's important to talk to your doctor about the underlying cause and severity of your dry eye symptoms. Your doctor may recommend different treatments depending on the cause and severity. These could include medications to reduce eye inflammation, increase tear production, or address the underlying condition, such as suppressing the immune system for autoimmune diseases.
More severe conditions
If you are suffering from more severe dry eye symptoms, your doctor may have more intense treatment options for you.
If you are experiencing moderate to severe dry eye symptoms, your doctor may recommend more intensive treatment options. One option is to use eye inserts made of hydroxypropyl cellulose, which are placed between the lower eyelid and the eyeball and release a lubricating substance to help soothe your eyes. Another option is tear-stimulating medication in the form of pills, gels, or eye drops.
If you are not responding to other treatments, your doctor may suggest more invasive options, such as autologous blood serum drops, which are made from your own blood, or surgical procedures to close tear ducts or unblock oil glands.
Conclusion
Dry eye syndrome is a common condition that can cause discomfort and interfere with daily activities, especially in the morning. However, with an understanding of the causes and the right management approach, it can be effectively managed. Whether it's due to biological factors, health conditions, medications, or other factors, it's important to work closely with your healthcare provider to identify the underlying cause of your dry eye and develop a treatment plan that works for you.
With a better understanding of dry eye and its effects, you can take steps to manage the condition and start your day with comfortable, healthy eyes, allowing you to live life to the fullest.
[1] Rolando, Maurizio, and Jesús Merayo-Lloves. “Management Strategies for Evaporative Dry Eye Disease and Future Perspective.” Current eye research vol. 47,6 (2022): 813-823. doi:10.1080/02713683.2022.2039205
[2] Akpek, Esen K et al. “Dry Eye Syndrome Preferred Practice Pattern®.” Ophthalmology vol. 126,1 (2019): P286-P334. doi:10.1016/j.ophtha.2018.10.023
[3] Lee, Young Bok et al. “Sleep deprivation reduces tear secretion and impairs the tear film.” Investigative ophthalmology & visual science vol. 55,6 3525-31. 15 May. 2014, doi:10.1167/iovs.14-13881
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