Dry eyes usually occur when the body produces insufficient tears to moisturize the eyes. This may cause itching and vision problems.
Dry eyes are a common health concern, affecting nearly 16 million peopleTrusted Source in the United States.
They are typically caused by an insufficient production of fluid, or tears, which moisturize the eyes.
Dry eyes often resolve on their own. However, some people may require various treatments or home remedies to alleviate symptoms.
In this article, we discuss some of the causes of dry eyes at night, the common symptoms, and the treatment options.
lubricates the eye
removes foreign materials that may cause damage or infection
keeps the eye’s surface smooth and clear
preserves eye health
The tear film is made of three layers:
Outer lipid: This oily layer prevents the tear film from evaporating too quickly and keeps the surface smooth.
Middle aqueous: This layer makes up most of the tear film and washes away foreign materials to reduce the risk of infection, irritation, and damage.
Inner mucin: This layer spreads the watery film evenly over the eye’s surface and helps tears stick to it.
Dry eyes happen when there are not enough tears to moisturize the eye. This may lead to a number of symptoms, such as:
stinging, burning, or itchy eyes
red 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
Causes
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.
Below is a list of potential causes for dry eyes.
Nocturnal lagophthalmos: This is a condition where people 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. People over age 50Trusted Source are more likely to have dry eyes.
Hormonal factors: Pregnancy, menopause, and contraceptive pills may make it harder for the body to produce tears.
Medical conditions: Certain chronic conditions may increase the risk of developing dry eyes, such as Sjögren disease, rheumatoid arthritis, diabetes, and thyroid conditions.
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, such as LASIK, may reduce tear production.
Long periods of screen-based device use: Excessive screen use without sufficient blinking could cause dry eyes and eyestrain.
Environmental factors: Exposure to wind, smoke, pollution, or allergens could lead to dry eyes.
Medications: Certain medications reduce tear production, including some antihistamines, diuretics, oral corticosteroids, and antidepressants.
Nutritional deficiencies: Not eating enough nutrients that support the tear film or eyes, such as vitamin A and omega-3 fatty acids, may also cause dry eyes.
Treatments
Treatment for dry eyes at night will depend on the severity, cause, and frequency of a person’s symptoms. The different treatment optionsTrusted Source focus on either producing, adding, or maintaining tears in the eyes.
Eye drops
Over-the-counter (OTC) artificial tears or eye drops are the most common first-line treatment to help lubricate the eyes.
There are two types of eye drops. Demulcent agents are applied directly to the eye surface and are water soluble, while emollient agents are typically applied on the eyelids and are a fat or oil.
An alternative treatment to artificial eye drops is Aero Pump spray. This spray bottle produces a very soft, fine mist that does not cause blinking when applied.
However, Aero Pump spray is a new treatment that is not available in the United States at this time.
It is best to choose preservative-free eye drops or spray solutions with fewer ingredients that may cause irritation.
Prescription medications
If OTC eye drops do not alleviate a person’s dry eyes at night, a doctor may prescribeTrusted Source cyclosporine (Cequa) or lifitegrast (Xiidra). These are eye drops designed to help produce more tears.
Similarly, a person can speak with a doctor about suitable alternatives to medications that are causing dry eyes in the first place.
A doctor may also prescribe anti-inflammatory ointments, eye drops, or eyelid washes to help treat eye or eyelid inflammation.
Blocking tear ducts
Some people may need to block their tear ducts to prevent tears from draining.
This involves blocking tear ducts with tiny gel or silicone plugs to keep natural tears in the eyes for longer.
Surgery
Surgery may be required for people whose eyelids are too loose, which may allow tears to drain too quickly. These procedures help with nocturnal lagophthalmos.
Pulsation systems
Thermal pulsation or intense pulse light are two new types of therapy that may help treat dry eyes by stimulating the meibomian glands. These glands are located along the edge of the eye and produce the oil of the outer lipid layer, which helps keep the eye moisturized.
Home remedies
Several at-home remedies may also help relieve dry eyes at night, includingTrusted Source:
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 ultraviolet-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
When to contact a doctor
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, chronic, or do not respond to at-home care or OTC treatments.
If not managed, chronic dry eyes may lead to cornea damage or vision loss.
Frequently asked questions
What deficiency causes dry eyes?
People who do not consume enough vitamin A or omega-3 fatty acids may have a higher risk of dry eyes, according to the National Eye InstituteTrusted Source.
Summary
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 for people to speak 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.
Last medically reviewed on September 13, 2023
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