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Dry eyes at night only?

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  • Dry eyes at night only?

    Hello all, this is my first post here and I was curious if anyone else had similar experiences to mine. I've poked around and it seems like dry eyes has a wide variety of symptoms and causes.

    I used to not be able to sleep without a ceiling fan on full blast. I lived for 30+ years with lots of air flow while I slept because it felt good. Then in the span of a couple days my eyes decided to dry out. I started waking up with intense pain in one eye or the other. I kept trying to get whatever was in my eye out, but it never came out.
    After a month of nighttime dry eyes, I went to a doctor and she diagnosed me with recurrent corneal abrasion. She told me to use drops during the day, and ointment at night. So for the last three years, I've been putting ointment in my eyes at night. It helps, but my eyes still dry out while I sleep.

    The thing that strikes me as weird about all this is that my eyes are fine during the day. Around 10pm every night, however, my eyes dry out. If I stay up for a couple more hours they stop feeling dry but they still dry out as soon as I get to sleep. Even with the ointment, my eyes dry out to the point where they stick to my eyelids, and my eyelids get stuck as well. What the ointment does do is if I massage my lower lids and skin around my eyes a little and roll my eyes down, the ointment is still there and it recoats my eye. Without the ointment, the same procedure seems to eventually wet my eye with watery tears that dissipate very quickly. Every 1-2 months I will have an episode where I wake up suddenly opening my eyelids and then the act of closing my eyelid seems to scrape across my eye. I did have one time where I managed to scratch my eye without even opening my lids, just moving my eyeball under the lid. These episodes happen in either eye with no discernible bias.

    I can deal with a daily routine, and I can even deal with the occasional pain in the eye. What I'd like to avoid is going blind. I am typically a light sleeper and find it very hard to sleep with goggle or masks on. I sleep on my side, which means anything protruding over my eyes will get pushed sideways by the pillow. I have a humidifier, which doesn't seem to help much (my house is already at 45% humidity most of the time.) At night, putting drops in my eyes seems futile. They dry out almost immediately and it seems that most of the liquid either drains away or gets pushed right out of the inside corner of my eyes when I blink. Gel drops work a little better, but they dry out very quickly as well. Ointment is the only thing that half stays put, but even a good amount of that ends up under my lower lid instead of in it after a few minutes.

    Anyway, just thought I'd throw this all out here since I didn't get much help from the two eye doctors I've seen. I would post in the ask the doctor section, but I can't compress all that into 100 words.

  • #2
    I'm not sure I can tell you anything to help you, but I have a similar problem. Although I have at least some dryness during the day, the main problem of actual dryness is during sleep. I too wake up extremely dry, and I think the pain I experience is because of corneal abrasions, though I have not been diagnosed. However, I was recently given an additional punctal plug for my right eye and I have woken up with with less dryness as a consequence of this. Do you have any plugs? I still have only one plug in my left eye and I have definitely noticed a difference in the feeling of dryness between the two eyes, with the right one being less dry.
    My one major problem right now is that the pain in my right eye has not improved even though I have enough tears, usually even an excess of tears, which I can see when I look in the mirror. The pain may also disappear for a day but then return for several days at a time. I think this is related to some sort of corneal trauma, but I'm not sure what else I can do about it. I am also using ointment at night and tranquileyes.

    Have you considered the possibility that you might be sleeping with your eyelids partially open?

    Do you have any vision problems such as blurry vision?



    • #3

      Did the doctor who originally diagnosed your RCEs say anything about ABMD (anterior basement membrane dystrophy, also called map dot fingerprint dystrophy)? What kind of ointment did she prescribe: the classic petrolatum/mineral oil or a hypertonic like Muro 128?

      Night protection is an issue for many of us whether the problem is dry eye, RCEs or both. Physical barrier is essential for many of us when no lubricant can do it all. Unfortunately there may be no shortcut to trying out different products and seeing what you can tolerate. The Tranquileyes goggle is very popular and although it looks bulky, the majority of people who try it are able to adjust to it. Beyond that there are various sleep masks. Taping the lids shut is definitely worth a try if you have trouble with night eyewear and are stuck in an erosion cycle.
      Rebecca Petris
      The Dry Eye Zone


      • #4
        Vijay, I had an "erosion" event (mistyped abrasion in my previous post) in my left eye this morning and it is still blurry. I need to ask my wife if she can tell if my eyes are slightly open when I'm sleeping, but I'm typically a really light sleeper so it may be difficult for her to check without waking me up.

        Rebecca, my original doctor told me nothing about causes for dry eyes (apart from obvious things like air movement and humidity), nor did the second doctor I saw. They both seemed to regard it as something that just happens, who knows why. The doctor told me to use the normal petroleum/mineral oil ointment, and nothing else I've tried has lasted longer than 30 minutes at night. The only reservation I have with taping my eyelids shut is the fact that I've hurt my eye simply by moving it under the lids when they were really dry. Assuming AMBD is the cause, does it explain the sudden onset? Honestly, I went from being able to sleep with a table fan pointed at my face to painfully dry eyes in a short span of time.

        BTW, I'd like to thank you for this site. I wish it was ranked higher in google's results, I might have found it sooner.


        • #5
          One word for your problem (as RP says): Tranquileyes!!!!!

          Don't trust any refractive surgeon with YOUR eyes.

          The Dry Eye Queen