Miya Pearson
Sleeping with your eyes open is usually an indication of a health problem, such as nocturnal lagophthalmos, which can cause blurry vision, dry eyes, sensitivity to light, red eyes, and the feeling of something being stuck in your eye. It is also harmful to sleep with contact lenses on, as it can increase the risk of eye infections and reduce oxygen flow to the eye. Upon waking, you may notice eye sleep or rheum, a combination of eye debris and hardened tear film that collects in the corners of your eyes and dries up overnight. While rheum is typically harmless, changes in its colour, consistency, or quantity could indicate an eye infection or disease.
| Characteristics | Values |
|---|---|
| Eye sleep/rheum | A combination of eye debris and hardened tear film that dries up overnight |
| Colour | Yellowish or clear |
| Consistency | Crusty and hard, sticky and thin, or watery |
| Colour changes | Green, grey, or white signals an infection |
| Risks of sleeping with contact lenses | 6 to 8 times more likely to develop an eye infection, reduced oxygen flow to the eye |
| Symptoms of infection | Blurry vision, redness, excessive wateriness, sensitivity to light, fatigue in the eye, pain, dry eyes |
| Sleeping with eyes open | Could be a sign of a health problem, possibly nocturnal lagophthalmos |
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What You'll Learn
Contact lenses and eye infections
Contact lenses can increase the risk of eye infections if not worn, cleaned, and stored properly. The CDC identifies microbial keratitis as a serious type of eye infection in contact lens wearers, which can even lead to blindness or the need for a corneal transplant in severe cases. Microbial keratitis is caused by bacteria, fungi, or viruses, such as the herpes simplex virus (HSV). HSV can be transmitted to the eye by touching an infected area and then inserting contact lenses or touching the eye. When HSV enters the eye, it often infects the cornea, eyelids, and conjunctiva. Treatment for HSV keratitis may include topical medication and oral antiviral medicine. However, it is important to avoid steroid eye drops as they can cause the virus to multiply.
Bacterial keratitis, caused by bacteria such as Pseudomonas aeruginosa and Staphylococcus aureus, is another type of corneal eye infection common in contact lens wearers. It typically results from improper lens care or an eye injury. When contact lenses are not stored or cleaned correctly, bacteria can spread from the patient's skin or from an unsterile solution. Immediate treatment with antibiotic eye drops and topical steroids is necessary to prevent vision damage and ensure full recovery without permanent vision loss.
Fungal keratitis is a corneal infection caused by exposure to fungi such as Candida, Aspergillus, or Fusarium, which can be found in water, soil, or plants. Contact lens wearers are at higher risk for fungal keratitis if they use tap water to clean or store their lenses. Even having organic matter on your hands before inserting contact lenses can result in a serious eye infection. Treatment for fungal keratitis typically involves oral medication and antifungal eye drops, and early treatment is crucial to prevent eye and vision damage.
To reduce the risk of contact lens-related eye infections, it is important to practice proper lens usage, care, and maintenance. This includes removing contact lenses before sleeping, as sleeping in your contacts can lead to eye infections and other symptoms. It is recommended to remove contacts at least an hour before bed and have a pair of glasses to use during this time.
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Nocturnal lagophthalmos
There are several treatment options for nocturnal lagophthalmos. A doctor may prescribe artificial tears or suggest wearing moisture goggles at night to keep the eyes moisturised. Lifestyle changes, such as avoiding sleeping pills, can also be recommended. In some cases, surgery may be suggested, where a gold implant is inserted into the eyelid to act as a weight and keep the eye closed during sleep.
If a person suspects they have nocturnal lagophthalmos, they should consult a doctor or optician. The doctor will ask about any recent trauma or illness, the duration of symptoms, and their severity. They may also observe the eyes for a few minutes to check for twitching or opening. While sleeping with eyes open is generally not a cause for concern, long-term untreated nocturnal lagophthalmos can lead to damage to the eyes.
The specific causes of nocturnal lagophthalmos can vary. In some cases, it may be genetic or related to anatomical differences. It can also be associated with certain conditions, such as Moebius syndrome, a rare neurological disorder affecting facial and eye movement. Additionally, behavioural factors, such as certain habits before sleeping, may contribute to the condition.
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Rheum (eye discharge)
The crusty material that collects in the corners of your eyes after sleep is called "rheum", or eye discharge. Rheum is a thin mucus that is naturally discharged from the eyes, nose, or mouth, often during sleep. It dries and gathers as a crust in the corners of the eyes or along the eyelashes. It is produced by a combination of mucus (mucin, a thin watery substance, discharged from the cornea or the conjunctiva), meibum (an oily substance that keeps the eyes lubricated between blinks), nasal mucus, blood cells, skin cells, and dust.
Rheum is one of the ways in which your eyes keep themselves clean, discharging waste products and any potentially harmful particles that get trapped between the tear film of your eye and the inner eyelid. Your eyes are continuously producing rheum, even when you are awake. However, when you are awake, blinking causes rheum to be washed away with tears via the nasolacrimal duct. Since you do not blink during sleep, a small amount of dry rheum accumulates in the corners of the eyes.
While rheum looks unpleasant, it is a sign that your eyes are healthy and functioning normally and is generally nothing to be concerned about. However, changes in the colour or consistency of the rheum may be indicative of eye disease or infection. For example, the presence of pus in an instance of heavy rheum buildup can indicate dry eye, conjunctivitis, or other infections. Healthy rheum is typically clear or light yellow. If the mucus is very thick, green, dark yellow, or occurs with pain or redness in the eyes, it may be a sign of an eye infection. Other conditions, such as allergic conjunctivitis, can also increase the production of rheum in the eye, causing a considerable buildup.
Good eye hygiene, including removing makeup at night and keeping the eyes clean by wiping closed eyes with a clean, warm washcloth, can help reduce eye discharge. In people with dry eyes, eye drops may also help. If you are experiencing changes in eye discharge or other symptoms such as red or inflamed eyes, blurry vision, sensitivity to light, or eye pain, it is recommended to consult an eye doctor.
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Eye health and hygiene
Good eye health and hygiene are essential for maintaining healthy eyes and avoiding potential infections and other issues. Here are some important tips and information regarding eye health and hygiene, specifically addressing what happens when you sleep on your eye:
Eye Discharge or "Rheum"
When you sleep, your body produces a substance called rheum, also known as eye discharge or "sleep." This is a combination of eye debris, mucin (a thin, watery mucus), meibum (an oily substance), and any other debris that the mixture collects. While it may look unpleasant, rheum is a sign of healthy and functioning eyes, as it helps discharge waste products and harmful particles that get trapped between the tear film of your eye and the inner eyelid. During the day, blinking helps remove rheum before it hardens, but at night, it collects and hardens in the corners of your eyes or along your eyelashes, forming the crusty substance you find in your eyes when you wake up.
Contact Lenses and Sleeping
Sleeping with contact lenses on can have negative consequences for your eye health. It can increase your risk of developing eye infections and dry eye. Contact lenses can reduce oxygen flow to the cornea, leading to symptoms such as sensitivity to light, eye fatigue, pain, blurry vision, redness, and discomfort. It is recommended to remove contact lenses at least an hour before bed to give your eyes recovery time. If you accidentally sleep with your contacts on, use artificial tears to lubricate and loosen the lenses before removal. Then, give your eyes a break from contacts for a full day to allow them to recover.
Nocturnal Lagophthalmos
Sleeping with your eyes open could indicate a condition called nocturnal lagophthalmos. This condition can lead to dry eyes and potentially affect your vision. If you experience symptoms such as blurry vision, dry eyes, sensitivity to light, red eyes, or a feeling that something is stuck in your eye, consult an eye doctor. Treatments for nocturnal lagophthalmos include eye drops, ointments, eyelid weights, medical tape, or surgery in more severe cases.
Changes in Eye Discharge
While small amounts of rheum or eye discharge are normal, be mindful of any significant changes. Increased discharge, changes in colour (such as green, grey, or white), or alterations in consistency could indicate an eye infection or other issues. For example, thick eye discharge is a prevalent symptom of conjunctivitis, an eye infection that can be viral, bacterial, or allergenic. If you notice any unusual changes in your eye discharge, consult an eye doctor as soon as possible to address any potential concerns.
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Eye pain and sensitivity
Another possible cause of eye pain and sensitivity is corneal abrasion, which occurs when something gets trapped under the eyelid and scratches the cornea, the clear protective layer over the iris and pupil. This can result in severe pain, discomfort, and redness of the eyes. If something gets caught in your eye, it is recommended to flush it out with water or seek help from an optometrist instead of rubbing it.
Changes in the colour or consistency of eye discharge, also known as rheum, can also indicate eye problems. Unusual rheum may be a symptom of eye conditions such as dry eyes, conjunctivitis, blepharitis, or styes. Allergies, contact lenses, or eye injuries can also affect the production and composition of rheum. If you notice changes in your rheum, it is advisable to consult an eye doctor, especially if accompanied by symptoms such as red or inflamed eyes, blurry vision, or sensitivity to light.
Additionally, spending a lot of time in front of a computer can contribute to eye pain and sensitivity. This is because individuals tend to blink less when using digital devices, which can lead to dryness and discomfort. In such cases, it is important to take breaks, blink consciously, and practice good screen hygiene habits to reduce eye strain.
If you are experiencing persistent eye pain and sensitivity, it is always best to consult an eye care professional for personalised advice and treatment options. They may recommend artificial tear drops, ointments, or other specialised treatments to alleviate your symptoms and improve eye health.
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Frequently asked questions
Doctors refer to "sleep" in your eye as
Sleeping with contact lenses on can cause eye infections and dry eye. Contact lenses reduce oxygen flow to the eye, and the cornea requires constant access to oxygen to maintain eye health.
Remove your contact lenses as soon as you wake up. Use artificial tears to lubricate and help loosen your lenses. Avoid wearing contacts for a full day to allow your eyes to recover.
Sleeping with your eyes open is most likely a sign of a health problem called nocturnal lagophthalmos. When your eyes are unable to close properly, they dry out, which can lead to poor vision or loss of vision.
Small amounts of eye sleep are normal and should be yellowish or clear in colour. If you notice a change in colour, consistency, or quantity, it could be a sign of eye infection or disease.
