Many people struggle with dry eye symptoms that are particularly worse in the morning after sleep. This is a common complaint and can have a variety of causes including incomplete eyelid closure, problems with the cornea, and even recurrent corneal erosions. Each of these causes can have a myriad of treatment options that can remedy dry eye problems in the morning. Having an eye doctor evaluate your eye health and discuss all of your symptoms allows for the best and most accurate diagnosis and treatment.
Feeling of Dryness in the Morning
Upon waking, it is common for vision to be slightly blurred initially. Still, if this blurry vision persists after a few seconds or requires strenuous blinking to clear vision, it can be a sign of severe dryness in the eyes.
Another potential sign of dryness is dried debris in the corners of the eyes. This debris accumulates during the night and then is deposited on the corners of the eyes.
Usually, this is a sign that there has been an increase in dryness during the night.
Perhaps the most common and significant sign of dryness throughout the night is when the eyes feel as though there is something foreign in the eye.
This feeling can be described as irritation, pain, or a feeling of something scratching the eye.
Dry Eyes in the Morning from Incomplete Eyelid Closure
The most common cause of dry eye in the morning is an incomplete eyelid closure.
When the eyelids do not close appropriately, a small area of the eye is constantly exposed to the air.
The small fissure that is left unprotected throughout the night dries out as the tears evaporate off of the eye and are not replaced by blinking.
Causes of incomplete eyelid closure include anatomical differences, thyroid eye disease, and eyelid swelling or infection.
To treat the dry eye symptoms from incomplete eyelid closure, options include wearing a sleep mask, taping the eyelids closed, or using ointment before going to sleep.
Dry Eyes in the Morning from Corneal Dystrophies
Another cause of dry eyes in the morning is inherited corneal dystrophy or malfunction.
The most common corneal dystrophy of this type is Fuch’s dystrophy.
Fuch’s dystrophy is a problem with the inner layer of cells of the cornea. These cells control the flow of water into and out of the cornea.
From Fuch’s dystrophy, it is common to have the cornea swell and begin to pull water out of the tears. This results in dry eye-like symptoms in the morning.
Once the eyes are open and you are awake, the swelling subsides, and the dry eye symptoms are reduced.
Fuch’s dystrophy is treated with hypotonic saline eye drops or the use of a hair dryer in the morning to reduce corneal swelling.
Dry Eyes in the Morning from Recurrent Corneal Erosions
Recurrent corneal erosions are particularly worsened upon waking when the eyelids first open. The corneal erosion can be opened by the eyelid pulling on the healing wound.
If the wound becomes reopened, it will cause intense pain and irritation that can feel like severe dryness.
Recurrent corneal erosions are treated using a bandage contact lens, antibiotic eye drops, and hypotonic saline solutions.