Why nighttime symptoms only?

[Saros]

I was diagnosed with "mild-to-moderate" DES 8 years ago & have tried just about everything (Restasis, plugs, drops & ointments, a homemade "moisture mask") without any net benefit. But the funny thing is, I've got almost exclusively NIGHTTIME symptoms--& so I've been holding out hope that this is a CLUE of some sort, either to the specific nature of my problem, or how to treat it. Does anyone else have primarily nighttime symptoms?

The good part is, I have hardly any discomfort during the day. Then as I'm reading in bed at 11pm I start to feel the dryness--but I'm a 42 year old woman, so this is nothing special I'm told. But then comes the kicker: all night long, no matter how deep a sleep I seem to slip into, I wake up innumerable times with bone dry eyes, unable to move under my lids, and a nasty sensation in my corneas that is gradually relieved with saline drops (preservative-free) and lots of blinking and pressing on my eyelids. I never used to be a bad sleeper, but now I despair of ever again sleeping through the night--or even half the night.

Saros

[Rebecca Petris]

Welcome Saros!

But the funny thing is, I've got almost exclusively NIGHTTIME symptoms--& so I've been holding out hope that this is a CLUE of some sort, either to the specific nature of my problem, or how to treat it.

... all night long, no matter how deep a sleep I seem to slip into, I wake up innumerable times with bone dry eyes, unable to move under my lids, and a nasty sensation in my corneas that is gradually relieved with saline drops (preservative-free) and lots of blinking and pressing on my eyelids. I never used to be a bad sleeper, but now I despair of ever again sleeping through the night--or even half the night.

Ever heard of lagophthalmos? If not, read up about it and also ask your doc next time you go whether this could be your problem. Lagophthalmos is failure of the lids to close completely at night and this is a key reason many people experience night-only symptoms (or more severe symptoms at night).

I have this problem too. What I have had most success with is (a) warm compress before bed, (b) Dwelle eyedrops (we sell them here) which last longer for me than any gel or ointment ever did, and (c) tranquileyes eye mask (though I did not see the benefits of the mask until having used it for awhile).

Also, here's a link with more suggestions about dry eye at night like humidification etc.

[Saros]

Good thought!

Thanks, Rebecca. Lagophthalmos seems like the only possible cause of night-only symptoms, I agree. The funny thing is, I've seen four corneal specialists and not one thought my eye exam was consistent with this. And I do have DES by tear film assessment. But lagophthalmos seems so obvious a suggestion, it's surely worth an attempt at treating it. Great suggestion!

Saros

[Rebecca Petris]

Two common conditions that often contribute to dry eye symptoms and which in my opinion often go undiagnosed are lagophthalmos and meibomian gland dysfunction. I don't know why it is - maybe unclear diagnostic criteria or something. Dr. Latkany wrote a really interesting article about lagophthalmos in Cornea a year or so ago - well worth a read. I'll try and dig it up and will post it if it's not a copyright violation.