Do Your Eyes Feel Worse In The Morning?

If you suffer from dry eye, you may have noticed that your eyes feel worse in the morning, despite a good night’s rest. You’d think it’d be the opposite, but there are actually a few reasons why this is so. (hint: read on to find out!)

Nocturnal Lagophthalmos

I bet you didn’t know many people sleep with their eyes partially open. Because the eyes are not completely closed for several hours, the tears and corneal surface dry out, leading to symptoms of pain, scratchiness, mucous discharge, and/or foreign body sensation upon waking . Systemic conditions including Bell’s Palsy, tumors, paralysis, thyroid disease, and Grave’s disease can contribute to this issue. In-office diagnostic testing can determine if you are suffering from nocturnal lagophthalmos.

Change in Bodily Function

Although your lids are supposed to work as a seal when you sleep, lack of blinking leads to decreased tear production. Additionally, your body’s metabolic function slows down when you sleep, slowing tear production. Aging conditions such as tear gland damage, diabetes, thyroid disease, and autoimmune conditions can further exacerbate this issue.


As discussed previously, blepharitis is an inflammatory condition of the eyes caused by bacterial-overgrowth. These bacteria are active at night, causing dry eye-related symptoms of redness and irritation upon waking.

Environmental Factors

Sleeping directly in front of or under air vents, ceiling fans, and/or heating units can contribute to ocular surface dehydration. Additionally, sensitivity to allergens accumulated in bedding or around the bedroom can dry out eyes, causing red, itchy, irritated eyes.


Each of these factors contribute to dry eye disease differently, and therefore, lead to a different ocular surface presentation. A comprehensive evaluation will determine the cause(s) and our doctors will design treatment plans which may include the use of lid scrubs, sleep masks, humidifiers, and/or ointments. Call us today to schedule an assessment!


Aamena S. Kazmi, OD
Therapeutic Optometrist
The Dry Eye Doctor at BFEC

Check out Just Add Water? A Dry Eye Series by the Dry Eye Doctor

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