This Is The Reason You Are Waking Up With Watery Eyes In The Morning

Getting some shut eye is great for overall health (including the eyes). But what happens when going to bed actually causes more issues for the eyes? Sometimes overnight, the eyes can dry out. You won’t notice this while sleeping, but upon wakening in the morning the eyes may feel dry or the vision may just seem more blurry than usual. But sometimes the eyes are watery!

Watery eyes are a sign of dry eye

In the morning or even throughout the day, watery eyes can mean that the eyes are actually drying out. Why watery? Sounds pretty counterintuitive.

Let's start by looking at what happens in dry eye disease

On the surface of the eye is a tear film. This tear film is made up of multiple different layers. At the very base of the tear film, a mucous layers exists to help the tear film conform to the surface of the eye. The bulk of tear film (approximately 90%), is the aqueous or watery layer; it's the liquid stuff we think of the most when we think of tears. Directly on the surface of the tear film is an oil layer which helps to seal the watery layer in and prevent your tears from evaporating away.

In a healthy eye, this tear film is nice and robust and thick and lasts in between blinks. In an eye with dry eye disease, this tear film is either too thin from not enough tears being produced or this tear film has a poor oil layer and evaporates too quickly. In either case the tear film inadequately provides coverage to the cornea and parts of the cornea dry out.

The causes of a poor oil layer on the tear film

As stated above, the oil layer on the surface of the cornea is responsible for keeping all the tears in place on the surface of the eye. This oil layer can be disrupted from two main causes:

• This oil layer is produced by tiny little glands in the eyelids called meibomian glands. If the oil being produced in these glands isn't of the right consistency, then these glands can become clogged and prevent oil from flowing properly onto the surface of the eye. This is a common condition called meibomian gland dysfunction and as a result there just aren't enough oils on the surface of the eye.
• But there is another common condition called blepharitis. In this condition, there is an overgrowth of normal skin flora around the base of the eyelashes. These bacteria are harmless (since they normally exist on your skin); it's not really an infection. The problem is that these bacteria can secrete chemicals into your tear film which cause the tear film to break up.

The end result of either of these two conditions is you have a tear film which does not last in between blinks. Because the cornea becomes exposed, it drys out.

Back to watery eyes

When the body detects that the eye is drying out, it has a reflex to produce more tears. These tears are produced by the lacrimal gland directly onto the surface of the eye and they make up the aqueous layer of the tear film.

So what happens when your dry eye is caused by a poor oil layer but you still have enough of the watery aqueous layer? The production of more watery aqueous tears becomes too much for your eye. Your oil layer isn't robust enough to handle the tear production and the eye becomes watery as a result. These new aqueous tears aren't able to fix your dry eye because the dry eye is caused by the poor oil layer. Your eye is watery despite the fact that it is still dry. So waking up with watery eyes is in most cases due to the eye drying out.

What causes the eyes to dry out overnight?

Your eyes are closed while sleeping. Right? Yes, but sometimes the eyelids won't shut completely over the surface of the eyes. This is called nocturnal lagophthalmos. This leaves a small amount of the eye exposed to the elements. Overnight this thin strip of the eye can continuously dry out. As this part of the eye drys out, the dry eye will get worse and the body starts to mount its tear production response to fight back against the dry eye. You may notice some extra "eye sleep" or "eye gunk" or crust in the corner of your eyes as a result of excess tear production.

Upon waking up, the eye is still dry and the body is still producing excess tears: the eyes are watery.

So what can be done to prevent waking up with watery eyes?

The main goal is two fold: we want to treat the causes of dry eye and we want to prevent the eye from drying out overnight.

To figure out the optimal treatment for your eyes, a visit to your eye doctor is in order. After all, you won't be able to see what is causing your dry eye. But fortunately, the treatments for blepharitis and meibomian gland dysfunction are easy without much downside.

• For blepharitis, special lid scrubs exist which can clean away the excess build-up of bacteria on the eyelids. It's not a cure, the bacteria will more than likely grow back, but when done regularly, the lids scrubs are able to maintain clean eyelashes and prevent the blepharitis from breaking up the tear film.
• For meibomian gland dysfunction, the goal is to get the oil produced properly and to get the oil flowing again. Fish oil or omega-3 supplements are used to help improve the consistency of the oil produced by the meibomian glands. Producing better oils prevents the oils from becoming clogged in the glands. Warm compresses on the eyes will heat up the current oils to thin them and allow the oils to flow easier onto the surface of the eye. Both treatments will improve the natural oil layer on the surface of the eye.

In addition to treating the causes of the dry eye, you will also want to prevent the tears from evaporating away at nighttime. The best way this is achieved is with a lubricating ointment. A thin strip of lubricating ointment is placed on the eyelid; blinking then smears a thick protective coat of the ointment all over the surface of eye. This protective coat provides an extra thick barrier protecting the eye from drying out. Of note, these ointments are so thick that they will actually blur vision after putting it in the eye. A little annoying, yeah, but not too big of a deal right before bedtime. Lubricating ointments are easy to find in any drugstore and often are marketed exactly for use at nighttime.

In addition to the lubricating ointment, it's also helpful to turn off fans at night-time. Tabletop fans and ceiling fans having their cooling effect by causing evaporation off of skin. These fans will also cause evaporation of the tears from the surface of the eye; which isn't what we want. So turning off the fans can help prevent extra drying out at night.

If you are waking up with watery eyes, there is hope. The most common cause of this is dry eye overnight. By starting treatments and preventing your eyes from drying out while sleeping, you can go back to healthy normal eyes.

Related Articles