Dry Eyes at Night: Symptoms & Treatments

Dry eyes usually get worse as the day progresses. That’s why symptoms are often worse in the evening or at night.

Eyes are exposed to various irritations during the day, and these trigger dry eyes.¹ Furthermore, tear fluid production decreases at night.² If you already have dry eyes during the day, you may notice that your symptoms get worse at night.

Severe symptoms may even impact sleep quality, and since sleep quality is another risk factor when it comes to dry eyes, it is vital to address the problem.

Symptoms of Dry Eyes at Night

Like during the day, dry eyes at night cause eyes to be red, burning, and itching. Many people also experience a sensation that feels like having a grain of sand in the eye. These symptoms worsen at night.

Additional symptoms include

Red and swollen eyes in the morning
Sticky eyelashes and eyelids
Increased production of eye secretions, resulting in dried rheum (sleepy dust)

Treatments

Treatments that help to improve dry eye symptoms in general will also help with dry eyes at night. Here are some therapeutic approaches for the treatment of dry eyes:

Eliminate the Cause

When the dryness persists over a long period, it’s crucial to find the cause of the symptoms. Certain diseases, such as diabetes or hypothyroidism, can favor the development of dry eyes.^3,4Once the condition is adequately treated, dry eye symptoms usually improve.

Certain medications, such as antidepressants, can also cause dry eyes as a side effect. Speak to your doctor about using alternative products.

Avoid Unfavorable External Factors

External factors such as dry air or contact lenses can promote eye dryness.⁵ Working in front of a screen for many hours every day can also cause dry eyes. The eye surface gets moisturized with each blink. The blink rate, however, drastically decreases when staring at a screen.⁶ A software that measures eyelid movements and regularly reminds you to blink can actively increase your blink rate and keep your eyes moisturized.

Some treatments are particularly suitable for application at night-time and can, at the same time, relieve nightly symptoms:

Eye Drops

Most eye drops are suitable for use during the day because they are highly fluid and do not stay in the eye for a long time. But eyedrops can also have a higher viscosity, which can be a problem during the day because it causes blurred vision. However, at night, high viscosity is beneficial because the product stays in the eye for longer and has a longer-lasting effect.

Eye drops that contain carbomers, cellulose derivatives or a high concentration of hyaluronic acid (0.4% or more) tend to be more viscous and therefore more suitable for nighttime use.^7,8,9,10

Eye Gels & Ointments

Eye gels are more viscous than eye drops and are therefore suitable for nightly application. Eye ointments are even more viscous. They stay in the eye for many hours, moisturizing it and promoting nightly regeneration.

Humid Eye Mask

If you experience dry eyes mostly at night, this can be the result of eyelids not closing completely, which causes the evaporation of tear fluid. This effect is especially pronounced at night because tear production goes down, and no lid movements are moisturizing the eye surface. Wet compresses that cover the eyes, like an eye mask, can counteract this effect. They prevent tear film evaporation and also provide moisture from outside.¹¹

Increase Air Humidity

Dry air promotes dry eyes. If you spend the whole day in air-conditioned or heated rooms, you are probably affected by this. Air humidity can easily be increased with the help of humidifiers. Your bedroom should also have sufficient air humidity to prevent dry eyes.

Dry eyes are more than just a nuisance. Left untreated, they can get worse and cause further damage. If you struggle with dry eyes at night, try these treatments to help relieve symptoms and improve eye health.

References

1. Dry Eye. https://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/dry-eye. Accessed October 25, 2019.

2. Ayaki M, Tachi N, Hashimoto Y, Kawashima M, Tsubota K, Negishi K. Diurnal variation of human tear meniscus volume measured with tear strip meniscometry self-examination. PLOS ONE. 2019;14(4):e0215922. doi:10.1371/journal.pone.0215922

3. Zhang X, Zhao L, Deng S, Sun X, Wang N. Dry Eye Syndrome in Patients with Diabetes Mellitus: Prevalence, Etiology, and Clinical Characteristics. Journal of Ophthalmology. 2016;2016:1-7. doi:10.1155/2016/8201053

4. Kan E, Kılıçkan E, Ecemiş G, Beyazyildiz E, Çolak R. Presence of Dry Eye in Patients with Hashimoto’s Thyroiditis. Journal of Ophthalmology. 2014;2014:1-4. doi:10.1155/2014/754923

5. Kojima T. Contact Lens-Associated Dry Eye Disease: Recent Advances Worldwide and in Japan. Investigative Opthalmology & Visual Science. 2018;59(14):DES102. doi:10.1167/iovs.17-23685

6. Freudenthaler N, Neuf H, Kadner G, Schlote T. Characteristics of spontaneous eyeblink activity during video display terminal use in healthy volunteers. Graefe’s Archive for Clinical and Experimental Ophthalmology. 2003;241(11):914-920. doi:10.1007/s00417-003-0786-6

7. DeLuise VP, Peterson WS. The use of topical Healon tears in the management of refractory dry-eye syndrome. Annals of ophthalmology. 1984;16(9):823-824. http://www.ncbi.nlm.nih.gov/pubmed/6508097. Accessed November 21, 2019.

8. Guillaumie F, Furrer P, Felt-Baeyens O, et al. Comparative studies of various hyaluronic acids produced by microbial fermentation for potential topical ophthalmic applications. Journal of Biomedical Materials Research Part A. 2009;9999A:NA-NA. doi:10.1002/jbm.a.32481

9. Verma DrS. Polymers in designing the mucoadhesive films: A comprehensive review. International Journal of Green Pharmacy. 2018;12(2). doi:10.22377/IJGP.V12I02.1783

10. Solomonidou D, Cremer K, Krumme M, Kreuter J. Effect of carbomer concentration and degree of neutralization on the mucoadhesive properties of polymer films. Journal of Biomaterials Science, Polymer Edition. 2001;12(11):1191-1205. doi:10.1163/156856201753395743

11. Kurihashi K. Moisture Aid during Sleep for the Treatment of Dry Eye: Wet Gauze Eye Mask. Ophthalmologica. 1994;208(4):216-219. doi:10.1159/000310492