Why are my eyes red when I wake up?

Don’t worry: According to Meenal Agarwal, OD, an optometrist in Ontario, Canada, bloodshot eyes in the morning usually mean something irritated or dried out your eyes overnight. In certain cases, though, red eyes can indicate things like an infection or an underlying eye condition.

Find out here the most common causes of red eyes in the morning and what you can do to relieve and refresh them.

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7 Causes of Red Eyes When You Wake Up

1. You have dry eyes

One of the most common reasons for red eyes in the morning is dry eyes, says Dr. Agarwal. “When we sleep, our eyes naturally produce fewer tears. This can cause your eyes to feel dry and irritated, which can lead to red or bloodshot eyes in the morning,” she explains. Dry eyes in the morning may also be accompanied by stinging or burning, sensitivity to light, or the feeling that something is gritty in them.

Dry eyes can happen to anyone at any time, but you may be more susceptible to them in the morning if you spent hours scrolling through your phone the night before. In fact, staring at a screen causes you to blink less, which can cause or worsen dry eyes, the Mayo Clinic says. Sleeping in a dry room or being dehydrated can also cause you to wake up with dry, red eyes, Dr. Agarwal says.

2. Your eyes are tense

Eye strain and dryness often go hand in hand, and both can make your eyes red. “Nowadays, we see eye strain as a major cause of red eyes, even in children,” Dr. Agarwal says. Again, “we stare a lot and don’t blink when we’re looking at screens or reading in low light, so we wake up with bloodshot eyes,” she adds. Even playing video games or spending time on hobbies that require intense eye focus (like sewing or crafting) into the wee hours of the morning can put a strain on your eyes.

In addition to redness, strained eyes may also feel watery, itchy, or burning. They may also feel tired, to the point where you may have trouble keeping your eyes open, according to the Cleveland Clinic.

3. You are sleep deprived

This may seem obvious, but an extreme lack of sleep can also be a reason you wake up with bloodshot eyes. It’s true: Consistently staying up too late (or disrupting your sleep all night) can make your eyes look like they’re on fire. In other words, red eyes from lack of sleep look tired and irritated. “This can cause the blood vessels in your eyes to dilate, making them appear redder,” Dr. Agarwal explains.

4. They are allergies

Environmental allergies (to things like pollen, grass, ragweed, mold or even dust) that aren’t properly managed can also cause your eyes to become red and itchy during the day or night. They may also be accompanied by other allergy symptoms such as congestion, sneezing, coughing, fatigue, shortness of breath or a skin rash, according to the American College of Allergy, Asthma, & Immunology (ACAAI).

This type of redness is likely caused by histamine, a chemical your body releases when it comes into contact with an allergen. In an attempt to clear the allergen from your body, histamine triggers a cascade of inflammatory responses, including dilating the blood vessels in your eyes, according to the ACAAI. The result? Lots of redness and irritation.

5. You have pink eye

When you wake up and your eyes are extremely swollen, watery, crusted, And red, then you may have pink eye, a contagious eye infection caused by a virus or bacteria, according to the Centers for Disease Control and Prevention. While it’s possible for both eyes to have pink eye at the same time, it’s more common in just one eye and is caused by contact with someone who is infected. For example, maybe you shared a washcloth with someone in your household who is infected and woke up with red eyes.

If you are not sure whether you have conjunctivitis or just terribly dry eyes, certain symptoms can give you a clue. Pink eye often causes a sticky discharge, while dry eye discharge is usually stringy. Pink eye also often comes on suddenly, while dry eye is often a problem that comes and goes, Dr. Agarwal explains.

6. It is uveitis

Uveitis, which in medical jargon is an inflammation in your eye, could be one of the reasons why you think you have an eye infection. Why are my eyes red all the time? This type of inflammation can stem from an infection, but it can also be a chronic side effect of certain autoimmune conditions like inflammatory bowel disease or rheumatoid arthritis. While you may notice more redness in the morning, symptoms like eye pain, blurred vision and sensitivity to light can occur 24/7, according to the National Eye Institute. If left untreated, uveitis can lead to vision loss, so don’t ignore it. Let your doctor know, and he or she can prescribe steroids to help clear up the inflammation.

7. You suffer from eyelid inflammation (also called blepharitis)

Blepharitis is an inflammation that specifically affects your eyelids. It’s usually a chronic problem that can occur when the oil glands at the base of your eyelids become clogged, causing them to become irritated and inflamed. That can leave your eyes red, watery, swollen, itchy, crusty or even oily, especially first thing in the morning, according to the Mayo Clinic. And while it can be true, swollen eyelids from blepharitis are especially common in people with rosacea, a skin condition that causes redness on the face, according to the Mayo Clinic.

How to Treat Red Eyes When You Wake Up

Whether your bloodshot eyes are the result of lack of sleep or allergies and irritation, these treatment options can help:

Lubricating eye drops

If dryness is the culprit, lubricating eye drops (also called artificial tears) can help replenish hydration, making your eyes more comfortable and less red, Dr. Agarwal says. Try TheraTears Dry Eye Therapy.

Warm compress

Got crusting or toughness? Pressing a warm compress over your eyelids for a few minutes can help gently dislodge the gunk, says the American Academy of Ophthalmology (AAO). You can make a compress by soaking a small towel in warm water or heating a hot water bottle and placing it over your eye(s). Resist the urge to rub as you do this, as this can spread bacteria around your eyes and risk infection.

Medicines for allergies

If seasonal or environmental allergies are bothering your eyes, your doctor may recommend an allergy medication. Over-the-counter oral medications like Claritin or Zyrtec are typical first options, as they help manage symptoms throughout your body. If your eyes need extra attention, over-the-counter antihistamine eye drops for allergies (such as Alaway or Pataday) or prescription eye drops (such as Crolom or Alomide) are another good option, according to the Mayo Clinic.

Other prescribed medications

If you are dealing with an infection or inflammation, you may need a different type of prescription medication. For example, bacterial pink eye is usually treated with antibiotics, while uveitis usually requires steroids to suppress the inflammation. Your doctor will know which medication is best for you based on your symptoms.

Drops against redness

And as for anti-redness drops like Lumify or Visine? “While they won’t fix the underlying problem, they can help improve the appearance of your eyes,” Dr. Agarwal explains. The downside is that using them too often can actually cause rebound redness (similar to how using Afrin too often can make you more congested), according to the AAO. So use them sparingly, she advises, like if you get red eyes after swimming. If you’re using them more than once in a while, talk to your doctor to brainstorm other solutions.

How to prevent red eyes while sleeping?

Once you’ve got your redness under control, you may be wondering what to do to prevent it from coming back, especially while you sleep. Here are some strategies to try before you fall asleep:

• Controlling underlying conditions. If your doctor has prescribed medications to treat your eye problems, make sure you take them regularly.
• Limit your exposure to allergens. Keep irritants out of your home as much as possible by closing the windows, using a HEPA filter in your HVAC system, or using a HEPA-filtered air purifier, Dr. Agarwal advises. This is a great option for preventing allergies naturally.
• Turn on a humidifier in your bedroom. It can add moisture to the air to combat dryness, Dr. Agarwal says. Aim for 30 to 50 percent humidity; more than that can encourage the growth of mold and dust mites, which can make eye irritation worse, the Mayo Clinic says.
• Be aware of your screen usage. You know how it is: try to avoid or limit your screen exposure for at least an hour before bed. Not only will it relieve your eyes, it will also help you sleep better.
• Get enough sleep. Aim for 7 to 9 hours a night, the National Institutes of Health recommends. That will give your eyes the rest they need, so they’ll be less prone to redness and irritation in the morning.

When should you see an ophthalmologist?

Waking up with red eyes every now and then probably isn’t a big deal. But if it happens often, consider checking in with an eye doctor. “If you’re unsure or if your symptoms are severe, worsening, or accompanied by pain, vision changes, light sensitivity, or swelling in or around the eye, it’s best to see your optometrist for proper diagnosis and treatment,” Dr. Agarwal advises.

FAQ

Can dehydration cause red eyes?

Too little H2O can dry out tissues all over your body, including your eyes. “Our bodies produce tears to lubricate our eyes and wash away irritants, and tears are primarily made up of water. When you’re dehydrated, your body prioritizes using water for other vital functions, which leads to decreased tear production,” Dr. Agarwal explains. And when your eyes become dry from too few tears, they can also become red.

Can high blood pressure cause red eyes?

Usually, no, but it can lead to worse problems. Untreated high blood pressure can lead to hypertensive retinopathy, in which normal blood flow to your retina (the tissue at the back of your eye) is disrupted by damage to the blood vessels. Most people don’t have any symptoms at first, but it can eventually lead to vision loss, according to the Cleveland Clinic. Your eye doctor will typically check for signs of hypertensive retinopathy during a routine eye exam, so be sure to schedule regular visits.

Is conjunctivitis worse in the morning?

Pink eye can come on suddenly, so you might go to bed feeling great and wake up with a full-blown case of redness, swelling, itching, and lumpiness, Dr. Agarwal says. What? The discharge that often accompanies pink eye can build up around your eyelid while you sleep, leading to a bunch of nasty crusting when you first wake up, according to UpToDate.com.