Morning Dryness or Itchiness: Why Do I Have Pain in My Eyes in the Morning?

Morning Dryness or Itchiness: 
Why Do I Have Pain in My Eyes in the Morning? Why Do My Eyes Itch in Morning? Why Do I have Swollen Lids in the Morning?

Some patients have more dry eye symptoms in the morning instead of the afternoon. A few patients will say that they have morning redness and not in the afternoon.

There are 4 key reasons why one might have morning redness, dryness, and pain:
1. Allergies: even if there is not itching, one may be allergic to something in the bedroom. If you have itching, it makes allergy even more likely. 

If we find symptoms are partly due to allergy, there is a host of options that can help. 

A key option is to get rid of allergens. A favorite we used for our house for all our mattresses is the below.

Allergy tests (no needles) are no available at our office and most MD’s offices to help quickly determine the culprit. 

2. Demodex Mites/Bacteria–Blepharitis: this very common inflammation of the eyelids and meibomian glands which can cause allergic like symptoms and/or can cause the glands to clog and not release its precious oil which keeps the tear on the cornea and prevents morning redness, pain, dryness, itching. Demodex are mites. They love us and in some patients particularly loves the eyelash base and love to make their homes in the meibomian glands. Demodex is part of almost everyone’s eyelashes at some point in life if you live long enough, studies now show. The bacteria that can also infest the eyelashes are usually part of our normal flora (bacterial environment naturally on our body). So no need to freak out about this, but just treat them to keep them away from the eyelashes and eyelids.

3. Meibomian Gland Dysfunction: The glands that produce the oily layer of the tear film are located at the base of each eyelid. If not working properly, this loss of meibomian gland function leads to 

4. Autoimmune: patients with an underlying Autoimmune issue like Sjogrens Syndrome, Lupus, Rheumatoid Arthritis, Colitis, PAN, etc, can have morning symptoms. If the first 3-8 treatments on Step Ladder below do not help, or if a patient has joint aches/pains and dry mouth, I usually order an SJO test to assess risk of an autoimmune disease. 

If Swelling of your Eyelids is Your Main Concern:

1. First address all of the above issues with your eyeMD.
2. Avoid salty foods especially at night time as this will classically cause eyelid swelling
3. Avoid gluten for 2 months to see if this makes any difference & follow a low-inflammatory diet
4. Check with your PCP to be sure your heart and kidney function is normal. Be sure also you do not have diabetes.
5. If all that is normal, this is a genetic condition most likely and your only options are:
a. make up tricks: see YouTube
There are many such videos and I cannot say one is better than the other. I have no stock in any products they sell at all.
b. See Oculoplastic Surgeon to help tighten lid with many options including laser, fillers, surgery. 

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