Do you wake up each morning feeling like there’s sandpaper in your eyes? If so, you could be sleeping with your eyes open.
It may seem like just a weird habit, but it can be dangerous for your eyes if left untreated for a long period of time. Sleeping with your eyes open is medically referred to as nocturnal lagophthalmos. Lagopthalmos is usually caused by problems with the nerves or muscles in the face that make it difficult to keep your eyes fully closed.
You probably won’t know if you sleep with your eyes open unless someone tells you that you do, but if you wake up with dry eye symptoms, such as pain, redness, and blurry vision, it might be a good idea to check in with your doctor.
What are the symptoms?
We blink during the day and shut our eyelids at night for a very good reason. Shutting the eyelid covers the eyeball with a thin layer of tear fluid. Tears help to maintain a moist environment for the cells of the eye to function properly. The tear fluid also helps to flush out dust and debris.
Without proper lubrication, the eye can be damaged, scratched, or become infected. The symptoms of nocturnal lagophthalmos are related to the drying out of the exterior part of the eye.
They may include:
- redness
- blurred vision
- burning
- irritation
- scratchiness
- light sensitivity
- feeling like something is rubbing against your eye
- poor quality sleep
Causes of sleeping with your eyes open
Nocturnal lagophthalmos is typically related to a problem with the muscles or nerves of the face. Anything that causes weakness or paralysis in the orbicularis oculi muscle (the muscle that closes the eyelids), can lead to sleeping with the eyes open. Some examples include:
- Bell’s palsy
- trauma or injury
- stroke
- a tumor, or a surgery to remove a tumor near the facial nerve, such as an acoustic neuroma
- neuromuscular diseases
- autoimmune conditions, such as Guillain-Barré syndrome
- Moebius syndrome, a rare condition characterized by cranial nerve palsies
It can also be caused by an infection, including:
- Lyme disease
- chickenpox
- mumps
- polio
- Hansen’s disease (leprosy)
- diphtheria
- botulism
Nocturnal lagophthalmos can also be caused by physical damage to the eyelids. Eyelid surgery or scarring from burns or other injuries can damage the eyelid and make it less able to fully close. Bulging or protruding eyes (exophthalmos) caused by Graves’ ophthalmopathy, a condition commonly seen in people with an overactive thyroid gland (hyperthyroidism), can also make it more difficult to close the eyelids.
