Dry Eye in the Morning

Why do people wake up with dry eye in the morning, and what can be done to alleviate this issue?

Dry Eye in the Morning in Bellflower

Amplify Eyecare of Greater Long Beach

Understanding the Cause: Dry Eye in the Morning

Dry eye in the morning typically results from inadequate tear production or accelerated tear film evaporation. Why does this occur more frequently during the night?

The Root Cause: Nocturnal Lagophthalmos

Nocturnal lagophthalmos, the inability to fully close the eyelids during sleep, often leads to dry eye in the morning. It is associated with weakness in the seventh cranial nerve due to several potential causes:

  • Cerebellar artery injury
  • Trauma to the jaw or skull
  • Bell’s Palsy

Incomplete eyelid closure exposes the eyes to air, disrupting the tear film's continuity, leading to dry eyes upon waking up.

A 2020 study revealed nocturnal lagophthalmos not only instigates dry eye in the morning but also deteriorates sleep quality. It was found that overstimulation of Muller's muscle, responsible for keeping the eye open, can trigger this condition.

The Root Cause: Nocturnal Lagophthalmos
Who is More Likely to Have Nocturnal Lagophthalmos?

Who is More Likely to Have Nocturnal Lagophthalmos?

Several groups are more susceptible to experiencing nocturnal lagophthalmos, and thus, dry eye in the morning:

  • Young individuals: Due to various lifestyle and sleep habits, the younger population might face a higher incidence of dry eye in the morning.
  • Shift workers: Disrupted sleep schedules and irregular sleeping environments can increase the risk of experiencing dry eye in the morning.
  • People with facial nerve problems or facial trauma history: These individuals might experience nocturnal lagophthalmos more frequently, leading to dry eyes upon waking up.
  • Bell’s Palsy patients: As Bell's Palsy causes temporary facial muscle weakness, patients are more likely to suffer from nocturnal lagophthalmos, subsequently leading to dry eye in the morning.
Who is More Likely to Have Nocturnal Lagophthalmos?

Combatting Nocturnal Lagophthalmos: Preventive Measures

Addressing dry eye in the morning involves effective strategies such as:

  • Aromatherapy
  • Using warm eye masks
  • Taking a warm bath
  • Taping the eyelids closed during sleep.

Relaxing activities, like the warm bath, can increase your parasympathetic activity, which regulates the “rest and digest” function and decreases sympathetic activity prior to falling asleep. This may also reduce the stimulation of the Muller’s muscle.

Taping the eyelids closed physically keeps your eyes covered, which should help keep them better lubricated.

Artificial tears can also be a viable option to manage symptoms of dry eye in the morning.

Other Causes of Dry Eye in the Morning

While nocturnal lagophthalmos is a common cause, there are several other factors that can lead to dry eye in the morning:

  • Environment: Dry or windy climates can cause increased tear evaporation, leading to dry eyes. Similarly, indoor environments with air conditioning or heating systems can dry out the eyes.
  • Prolonged Screen Time: Spending long hours in front of a screen can reduce the frequency of blinking, causing tear evaporation and resulting in dry eyes.
  • Age: As we age, tear production naturally decreases. This can result in dry eye in the morning, especially in older adults.
  • Medication: Certain drugs such as antihistamines, antidepressants, and certain blood pressure medicines can reduce tear production.
  • Health Conditions: Some health conditions like Sjogren's syndrome, rheumatoid arthritis, and diabetes can cause dry eyes.
  • Contact Lenses: Long-term use of contact lenses can cause dryness and irritation, leading to dry eye in the morning.
  • Sleep Position: Sleeping with your face against the pillow can cause your tears to evaporate more quickly, leading to dry eyes in the morning.

Remember, managing these factors can help reduce the incidence of dry eye in the morning.

The Root Cause: Nocturnal Lagophthalmos

Common Questions

Yes, typically older females going through menopause are more prone to having dry eyes than others. Also people taking certain medications such as anxiety medications, antidepressants, antihistamines, antipsychotics, anti-muscle spasm medications, Accutane, beta blockers, contraceptives, as well as certain diuretic medications, are more prone to have dry eyes. Also people who are contact lens wearers who don’t properly take care of their contacts or are wearing contacts with low oxygen permeability may be more prone to dry eyes. Additionally, people who tend to work on a digital screen for a prolonged period of time can increase their risk of dry eyes.
You may have dry eyes if your eyes are feeling gritty, irritated, scratchy, foreign body sensation, burning, excessive watering/tearing, redness, or if you’re experiencing light sensitivity. Dry eyes can also cause blurred vision; you may notice you find yourself blinking more frequently in order for your vision to get cleared up after going in and out of focus due to an unstable ocular surface caused by dry eyes.
Dry Eye in the Morning
Dr. Ikeda cartoon


If you experience dry eye upon waking up, it is likely caused by nocturnal lagophthalmos. In addition to the suggestions listed above, a doctor can provide you with additional guidance on what to do to treat and resolve this issue. If you’d like to schedule an appointment for a consultation at Amplify EyeCare of Greater Long Beach, you can contact us at (562) 925-6591. Patients with dry eyes visit our clinic from all over California, and we are proud to be a leading provider of dry eye care for patients from Bellflower, Long Beach, Lakewood, and Los Angeles.

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I haven't actually used the optometrist side, so my review is limited to the vision therapy offered.  This office was recommended by my occupational therapist for the treatment of my double vision following a stroke.

Claire A.

Love this location. I had a brain injury accident from day one one. All the team make you feel you still important and hope in the horizon after when the medical system fell you miserably. Dr. Ikeda very professional and very understanding about your issue. Two tombs up.

Jim K.

My husband and I were immediately impressed with Dr Ikeda. I was hit by a car while cycling which caused broken bones and three brain injuries. The brain injuries caused double vision. Dr. Ikeda examined my eyes and got me started on vision therapy with his occupational therapist who specializes in vision therapy.  She (Chris) is absolutely great.  I am impressed with the array of tools used to help recover my binocular vision.  I am doing things I never thought were possible (balance boards etc).  Chris pushes me and keeps me motivated. I really enjoy my sessions with her.  The office staff is always friendly and they have a wonderful appointment reminder tool that makes it easy to keep my calendar up to date. I am happy the rehab center at Little Co. of Mary recommended them!!

Teresa S.

The Vision Therapy is handled in a separate office through a different door from the shared waiting room. Chris, the vision therapist, has a wide and varied assortment of tools, equipment and resources to best evaluate and treat most vision issues. After just a few visits, my double vision became easier to control, using exercises developed during the therapy process. It was time well-spent.

Joe M.

I have been coming here since I can remember. I love it here. The staff is so amazing and nice. They explain everything they gonna do and never make you feel rushed. Dr. Ikeda has always been my doctor and I would never want another one. He is the doctor for my whole family and is always asking how everyone is doing. I am also so crazy about picking out my frames and have to try so many and each person who helps me take the time and lets me try them all on. I would never want to go anywhere else! I definitely would recommend this office to anyone looking for a great eye doctor.

Kayla W.

This is not for the eye exam but for the frames selection portion. I brought my prescription from Kaiser here with my VSP insurance. The reception staff was very polite and professional.  Manny helped me to pick out frames and explain my coverage.  Very helpful and patient not like the individual at the other place I rated here on Yelp.  I was running late and he still helped me and was not bothered at all.  I am so glad I came here ..........very pleased.

Very professional staff and pleasant.

Daniel G.
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