Dry eyes at night can occur because of many reasons, including spending a long time in front of screens before going to bed. This problem is usually mild and may improve on its own. However, besides knowing the causes, it is also important to understand when you should see a doctor about dry eyes.

Causes of Dry Eyes at Night

The surface of the eye is protected by three layers of tear film: an oil (lipid) layer, a water (aqueous) layer, and a mucus (mucin) layer. These three layers work together to protect, lubricate, and maintain the health of the eye’s surface.

Dry eyes develop when tears are not stable or not sufficient to keep the eye properly lubricated. This condition may be caused by:

• Reduced tear production.
• Decreased tear quality.
• Tears evaporating too quickly.

Several factors that can cause dry eyes include:

• Age: Dry eyes are more frequently found in people over 65 years old.
• Hormonal changes: Pregnancy, hormonal contraceptive use, and menopause can reduce tear production.
• Certain health conditions: Glaucoma, diabetes, and thyroid disorders can be associated with dry eyes.
• Nocturnal lagophthalmos: A neurological condition that prevents the eyelids from closing fully during sleep, causing tears to evaporate more quickly.
• Medications: Antihistamines, antidepressants, and some other drugs can reduce tear production.
• Screen use: Long periods of screen time before sleep reduce how often you blink and can cause the eyes to become dry more quickly.
• Contact lenses: Wearing contact lenses for too long can make the eyes feel drier at night.
• Nutritional deficiencies: Inadequate intake of omega-3 fatty acids and vitamins A, D, and B12 contributes to dry eyes.

Dry Eye Symptoms

Dry eyes often cause a sensation of foreign bodies, a gritty feeling, or itchiness in the affecteed eyes. Other common symptoms include:

• Blurred or fluctuating vision.
• A burning or stinging sensation in the eyes.
• Increased sensitivity to light.
• Mucus or discharge from the eyes.
• Excessive tears  (epiphora).

Dry Eye Treatments

If dry eyes are linked to gadget or screen use, you can relieve them by giving your eyes regular breaks. When dry eye symptoms are related to contact lens use, it is best to limit wear time to no more than 14–16 hours per day.

For dry eyes caused by other factors, consult a doctor so you can receive appropriate treatment. Some treatment options include:

• Eye drops (artificial tears):
  Help lubricate the eyes and reduce dryness. Some products are available over the counter at pharmacies or supermarkets.

• Eye ointments:
  Provide longer-lasting moisture than eye drops. Because they can blur vision, they are best used at night.

• Prescription medications:
  Help reduce inflammation or increase tear production, such as: cyclosporine, lifitegrast, perfluorohexyloctane, and varenicline.

• Acupuncture:
  May help stimulate tear production.

• Tear duct obstruction:
  Partially closes the tear duct when tears drain away too quickly.

• Surgery:
  Performed in selected cases to help reduce tear evaporation.

When Should You See a Doctor?

Although dry eyes are usually considered mild, persistent dry eyes, especially at night, can be a sign of a serious medical problem.

Consult a doctor promptly if your symptoms do not improve despite lifestyle changes or the use of eye drops. You can also use the consultation feature in the Ai Care app, which can be downloaded from the App Store or Play Store.

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