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Epstein at views expressed in this editorial are solely those of theĪuthor and do not necessarily represent the opinions of theĮditorial board, Jobson Medical Information LLC (JMI), or any other You can read it here.Ĭhief Medical to share your perspective? Write Andy Morgenstern wrote a beautifully eloquent and moving obituary. Every optometrist practicing today was touched by her. Many of us worked with Beth at one time or another in the many roles she served for our profession. The likely conclusion? Tear stability is perhaps the most critical factor in maintaining homeostasis of the ocular surface.Įditor’s Note: It is with great sadness that I report the passing of Dr. Apparently, a healthy stable tear film in young kids remains protective whether the eyes are open or closed. Yet, rarely do these children have issues. This happens so frequently that worried parents asking if this is normal is among the more frequently Googled eye questions in this age group. Does exposure cause tear instability and lead to the signs and symptoms of dry eye, or are the signs and symptoms of exposure a result of an unstable and poorly protective tear film? In other words, are properly functioning tears important even while the eyes are closed?Ī probable answer is suggested by looking at infants and young children who sleep with their eyes open.

For a long time, my reasoning made sense, but more recently, I started to suspect that the relationship between exposure and dry eye was more complicated than I initially thought. They not only didn’t wake with discomfort, but also found their dry eye issues were dramatically reduced. This epiphany and subsequent management strategy, using nighttime moisture tight goggles was game changing for many patients. Eye closure also promotes healing and regeneration of ocular surface damage that occurs during the day. In simple terms, without normal blinking at night, closed lids are a much more effective protective barrier than tears. I explained this by considering how the eyes function normally and why we close our eyes at night. In comparing dry eye to routine patients, it was obvious that nocturnal lagophthalmos was much more common among the dry eye group. Virtually all reported dry eye symptoms that began early and only worsened as the day wore on. For patients who slept through the night, many shared that upon waking, their eyes felt like sandpaper and they could barely get them open in the morning.

The severely affected complained that their eyes were so dry when they slept that they had to keep a bottle of artificial tears on the nightstand in case they woke in the middle of the night. Beyond discovering poor lid closure or a band of inferior staining during the slit-lamp exam, just talking to the patient usually gave it away. Additionally, it can also be very drying to your eyes, so consider using eye drops before you go to sleep to increase moisture.Off the Cuff: The Importance of Stable TearsĪ few years ago, I unexpectedly found a surprising number of dry eye patients with night time exposure. Sleeping with your eyes open can also be disruptive, as it allows light to pour through, which stimulates the brain. The inability to fully close your eyes may also be a result of Graves' disease-an autoimmune disorder that causes an overactive thyroid-or floppy eyelid syndrome.Ī symptom of floppy eyelid syndrome is obstructive sleep apnea, in which the soft tissue in your throat temporarily relaxes, which narrows your airway and momentarily cuts off your breathing. Experts say that sleeping with your eyes open-a condition known as nocturnal lagophthalmos-may also be a sign of a stroke, thyroid disease, or facial nerve damage, according to CNN. According to the National Sleep Foundation, sleeping with your eyes open could be hereditary and a sign of an underlying health condition. If you're one in five people who sleep with your eyes open, you may want to call your doctor.