Many people will experience dry eyes at night. Dry eyes usually occur when the body produces insufficient tears to moisturize the eyes. This condition can cause itching and vision problems.
Several factors can contribute to an imbalance between the production and removal of tears, including excessive screen use, dehydration, and certain medical conditions.
Dry eyes often resolve on their own, but in other cases, various treatments and home remedies are available to alleviate the symptoms.
In this article, we discuss some of the causes of dry eyes at night, the common symptoms, and the treatment options.
Dry eyes are a common problem, affecting about 16 million people in the United States.
A film of tears covers the eyes with every blink. This tear film contains three layers:
- an outside oil layer that prevents the tear film from evaporating too quickly and keeps the surface smooth
- a middle water layer that makes up most of the tear film and washes away foreign materials to reduce the risk of infection, irritation, and damage
- an inner mucous layer that spreads the watery film evenly over the eye’s surface and helps tears stick to it
Having a healthy film of tears is important for good vision and eye health because it:
- lubricates the eye
- removes foreign materials to reduce the risk of damage or infection
- keeps the eye’s surface smooth and clear
Dry eyes develop when there is an imbalance between the production and removal of tears. The imbalance can be due to insufficient tear production, poor quality tears, or tears that evaporate too quickly.
Common causes of dry eyes include:
- Nocturnal lagophthalmos: People with this condition sleep with their eyes open due to damaged or weakened eyelids.
- Dehydration: Not drinking enough fluids may reduce tear production or quality.
- Age: It becomes harder to produce tears with age.
- Hormonal factors: Pregnancy, menopause, and birth control pills can make it harder for the body to produce tears.
- Medical conditions: Some chronic conditions, such as metabolic disease or Sjögren’s disease, can increase the risk of developing dry eyes.
- Wearing contact lenses: Long-term use of contact lenses may increase the risk of developing dry eyes, especially during sleep.
- Eye surgeries: Refractive eye surgeries may reduce tear production.
- Long periods of screen-based device use: Excessive screen use without sufficient blinking could cause dry eyes and eye strain.
- Environmental factors: Exposure to wind, smoke, pollution, or allergens could increase the risk of developing dry eyes.
- Medications: Certain medications reduce tear production, including some antihistamines, decongestants, and antidepressants.
- Nutritional deficiencies: Not eating enough nutrients that support the tear film or eyes, such as vitamin A and omega-3 fatty acids, can cause dry eyes.
Dry eyes can cause a range of symptoms, including:
- stinging or burning sensations in or around the eye
- redness in the eyes
- increased sensitivity to light
- blurred vision
- a scratchy or gritty feeling, as though something has become stuck in the eye
- stringy mucus around or near the eyes
- watery or watering eyes
- pain while wearing contacts
The best treatment for dry eyes depends on the severity and cause of the condition.
Some options for treatment include:
- Adding tears: People can try using over-the-counter (OTC) artificial teardrops or moisturizing ointments or gels. It is best to choose preservative-free solutions with fewer ingredients that can cause irritation.
- Maintaining tears: This involves blocking tear ducts, which drain tears, using tiny gel or silicone plugs to keep natural tears in the eyes for longer.
- Treating eye or eyelid inflammation: Doctors will prescribe anti-inflammatory ointments, eye drops, or eyelid washes to treat these conditions.
- Increasing tear production: Prescribed eye drops, such as cyclosporine, can increase tear production.
- Changing medications associated with dry eyes: A person can speak with a doctor about suitable alternatives to medications that are causing dry eyes.
- Surgery to strengthen and tighten the lower eyelids: These procedures can prevent tears from draining too quickly or help with nocturnal lagophthalmos.
Several at-home remedies may ease the symptoms of dry eyes. Some tips include:
- staying hydrated
- getting enough rest
- applying a warm compress to the eye, such as a clean washcloth bathed in warm water
- massaging the closed eyelid
- using OTC eyelid cleaners
- getting enough vitamin A and omega-3 fatty acids
- avoiding smoky, highly polluted, or dry environments and climates
- using a humidifier at home or work to keep the air moist
- wearing UV-protective sunglasses when outside or in bright conditions
- limiting time in front of screens and taking regular breaks
- avoiding having fans, heaters, or conditioners blowing air into the eyes
- wearing eyeglasses instead of contact lenses
- cleaning homes, bedding, and clothing to reduce allergen and dust exposure
- using air filters to remove allergens and foreign particles from the air at home or at the workplace, if indoors
Experiencing mild symptoms of dry eyes before or during sleep is usually not a cause for concern. The symptoms should go away on their own.
However, a person should talk with a doctor about dry eyes if their symptoms are severe or chronic or do not respond to at-home care or OTC treatments.
Many people experience dry eyes, particularly at night. Dry eyes may develop due to certain medical conditions, medication usage, or lifestyle and environmental factors.
It is important to talk with a doctor about severe or chronic dry eye symptoms or those that do not respond to at-home remedies or lifestyle changes. Without treatment, dry eyes can damage the cornea, which is the clear outer layer of the eye.