Dry eye syndrome, often a result of inadequate tear production to lubricate the eyes, can lead to discomfort and visual issues.
This condition is prevalent, with an estimated 16 million individualsTrusted Source in the USA experiencing it.
The primary cause of dry eyes is a deficiency in tear fluid production, which is essential for eye moisture.
While dry eyes can improve without intervention, certain cases may necessitate treatments or home remedies for relief.
This article explores the reasons behind nocturnal dry eyes, typical manifestations, and available therapeutic approaches.
The eyes and dry eye symptoms
Every time an individual blinks, a layer of tears spreads across the eye, serving multiple essential functionsTrusted Source:
- It keeps the eye moist.
- It helps to eliminate foreign particles, reducing the risk of injury or infection.
- It smooths the eye’s surface for clearer vision.
- It maintains overall ocular health.
The tear film comprises three distinct layers:
The top lipid layer: This oily surface layer inhibits the rapid evaporation of tears and ensures a smooth exterior.
The middle aqueous layer: This forms the bulk of the tear film, flushing away debris to minimize the likelihood of infection, irritation, or damage.
The bottom mucin layer: This foundation helps ensure even distribution of the moisture over the eye and secures the tears to the ocular surface.
Dry eye syndrome arises when there is an inadequate volume of tears to keep the eye sufficiently lubricated, leading to symptoms such as:
- A sensation of burning, stinging, or itchiness in the eyes.
- Reddened eyes.
- Heightened light sensitivity.
- Vision that may be blurred or impaired.
- A feeling that resembles the irritation of having a foreign object in the eye.
- The formation of string-like mucus in or around the eyes.
- Eyes that may excessively tear up.
- Discomfort while using contact lenses.
Causes
Dry eye condition occurs when the tear system is out of balance, which could result from inadequate production of tears, poor tear quality, or tears that evaporate too swiftly.
Here are some common causes for the occurrence of dry eyes:
- Nocturnal lagophthalmos: This condition involves the eyelids remaining partially open during sleep due to weakness or damage, leading to dry eyes.
- Insufficient hydration: A lack of adequate fluid intake can cause a decrease in the production or quality of tears.
- Aging process: As individuals age, typically past the age of 50Trusted Source, tear production may diminish.
- Hormonal changes: Changes due to pregnancy, menopause, or contraceptive use may impact the body’s ability to produce tears.
- Underlying health issues: Certain diseases, such as Sjögren’s syndrome, rheumatoid arthritis, diabetes, and thyroid-related disorders, can raise the risk for dry eyes.
- Contact lens usage: Wearing contacts, particularly over a long period or during sleep, may contribute to the development of dry eyes.
- Laser eye procedures: Operations to correct vision, like LASIK, may lead to decreased tear production.
- Extensive use of digital screens: Overuse of devices with screens can result in insufficient blinking, which contributes to dry eyes and eye fatigue.
- Environmental exposure: Being in environments with wind, smoke, pollutants, or allergens can cause the eyes to dry out.
- Medication effects: Some drugs, including certain types of antihistamines, diuretics, oral corticosteroids, and antidepressants, can reduce tear production.
- Dietary deficiencies: A diet lacking sufficient nutrients that support eye health or the tear film, like vitamin A and omega-3 fatty acids, can lead to dry eyes.
Treatments
Treatments for dry eyes at night vary according to the severity, cause, and how often the symptoms occur. The range of treatments availableTrusted Source aim to generate more tears, supplement existing tear volume, or stop tears from evaporating too quickly.
Eye Drops
The first standard treatment for lubricating the eyes is over-the-counter (OTC) artificial tears or eye drops.
There are primarily two categories of eye drops. Demulcent drops, which are water-soluble, are applied directly onto the eye surface, and emollient drops, containing fats or oils, are usually administered on the eyelids.
Another option instead of conventional eye drops is the Aero Pump spray, which emits a gentle, fine spray that can be administered without causing the eyes to blink.
Still, Aero Pump spray is a novel treatment and currently isn’t accessible in the US market.
When choosing eye drops, it’s advisable to go for options without preservatives and with fewer components that may cause irritation.
Prescribed Medication
Should OTC eye drops fail to provide relief, doctors might prescribe eye drops such as cyclosporine (Cequa) or lifitegrast (Xiidra), which are formulated to stimulate tear production.
Patients may also consult their doctor about substituting medications that contribute to their dry eyes.
Additionally, doctors might prescribe anti-inflammatory creams, eye drops, or eyelid cleaners to address any inflammation in the eyes or eyelids.
Tear Duct Plugs
For individuals who need to retain tears in their eyes longer, plugging the tear ducts can be an option.
This method uses small gel or silicone plugs to obstruct the tear ducts, preventing the tears from draining too rapidly.
Surgical Interventions
Surgery might be necessary for those with excessively loose eyelids, which may lead to faster tear drainage. These surgical procedures can address conditions such as nighttime lagophthalmos.
Thermal Treatments
New therapies like thermal pulsation or intense pulse light therapy can also be beneficial in treating dry eyes. These treatments aim to stimulate the meibomian glands, which are situated along the rim of the eyelid and produce oil for the tear film’s upper lipid layer, thereby aiding in eye moisturization.
Natural Treatments
There are several home-based strategies that can aid in alleviating symptoms of dry eyes at nighttime, such asTrusted Source:
- Ensuring adequate water intake to stay hydrated
- Prioritizing sufficient sleep
- Gently applying a warm, damp washcloth to the eyes
- Gently massaging the eyelids while they are closed
- Utilizing over-the-counter products designed for eyelid hygiene
- Consuming foods rich in vitamin A and omega-3 fatty acids
- Steering clear of environments filled with smoke, high pollution, or dry air
- Using a humidifier to add moisture to the air in living or workspace areas
- Donning sunglasses that block out ultraviolet rays when in bright or outdoor conditions
- Cutting down on screen time and taking frequent breaks to rest the eyes
- Avoiding direct exposure to air from fans, heaters, or air conditioners
- Opting for prescription glasses as an alternative to contact lenses
- Keeping homes free of allergens and dust by regular cleaning
- Employing air filtration systems to remove irritants and particles from the indoor air at work or home
When to contact a doctor
If you’re encountering minor dry eye symptoms just before or while sleeping, it’s typically not something to worry about. These symptoms generally resolve by themselves.
But if you’re dealing with intense, persistent dry eye symptoms, or if they aren’t improving with home remedies or over-the-counter solutions, it’s advisable to consult with a healthcare professional.
Summary
Dry eye syndrome is a common issue, especially during nighttime. Various factors, such as certain health conditions, medications, and environmental influences, can lead to the development of dry eyes.
Individuals experiencing persistent or severe dry eye symptoms that don’t improve with home management should consult with a healthcare provider. If left unaddressed, dry eyes can potentially harm the cornea, the transparent front part of the eye.
