Foggy vision in the morning, how to find the cause?

[Mastiff]

I most often wake up with foggy vision in the morning. Not blurry, foggy, like haze/halo around light sources, etc. When I wore hard contacts, this was the visual effect when the lenses totally dried out. I was going on the assumption that this was caused by my eyes being totally dried out, and it does (mostly) go away after about 5 minutes of blinking. But I think there are at least a few other potential causes, one would be that I have a layer of oily stuff (meibum?) on my eye that isn't diluted right. Once in a while I try ointment at night and the foggy effect is worse than ever in the morning, so it makes me think of this. In fact, it takes at least an hour in the morning for the goop to stop messing with my vision after I use the ointment at night. Is this normal? Anyway, the last thought is that I have corneal swelling (edema) in the morning for some reason. I've had this before related to irritation from contacts, and the visual effect is similar.

Any thoughts on any of this? I'm not sure how to proceed. I just went to a new optometrist with high hopes (dry eyes and MGD listed on their web site), but the person knew less than me about the subject and gave me a bunch of coupons for drops and an Rx for doxy. I specifically asked her to check if my glands were plugged up and she wouldn't say definitively (must not know how to tell). sigh.

[peter56]

Hi Mastiff,
how Long time you have worn contact lenses?
Are your eyes-conjunctiva pink-red in the morning?

Many dry eye-MGD patients do get more problems in the morning.
Many people have no complete lid closure while sleeping. That means the very thin tear film does
evapoate even more rapidly. Furthermore the water of the meibum right at the MG orifices does
evaporate too and the meibum is getting sticky-stiff.
Since there is almost no blinking in the night, even in healthy eyes the tear film in very thin during the sleeping phase.

1. Please obtain a gel or other eye mask for the nights.
2. Apply a gel before going to bed.
3. Please obtain Muro-128 or AKorn 5% salt drops and for the night 5% ointment.
If you suffering corneal-stromal edema, the Muro drops and ointment should help.
The salt drops also stimulate the watery tears production.
If there are edemas in the cornea, the nerves there belonging to the tears c
reflex arc can't control-stimulate the tears production very well.

Ask your optometrist for some BUT measurements!

[Mastiff]

Thanks for the reply. I wore RGP lenses for about 3 years, but discontinued about 5 years ago. My eyes are slightly red in the morning, but not alarmingly so. They whiten up pretty fast most days.

I have been using the onyx eye mask at night, which is the best so far for keeping light out and making an okay seal. It's very humid inside there, sometimes it even drips out. I have tried Systane and Refresh ointments. My vision is still foggy, or maybe worse, with these, and my eyes feel goopy half of the next day. I also have tried Systane gel drops but they don't seem to do much. I'm planning to try Celluvisc next, but I don't have high hopes.

Regarding Muro, I looked into it, but am unclear if it's appropriate until you know for sure you have edema. Sucking the moisture out of the eye with salt may be ill advised for standard dry eye. If anyone knows otherwise, please let me know! Thanks.

Regarding TBUT, I'm still looking for a doc around here who even knows how to do it. For someplace with typical humidity in the single digits, we don't have much dry eye support.

[spmcc]

Hi Mastiff,

As I always recommend, if you add your location to your profile, people will be perhaps be able to help you with info specific to your area. Your location doesn't have to be exact... it could just be your country (see the top right corner of this post and you will see my location). It does help people when they go to give you advice...

Anyway, about Muro... I started using Muro drops about 4 years ago. They helped and I wondered why my cornea specialist never mentioned them. So, at my next follow-up (PLEASE always have follow-ups scheduled!! We have chronic problems that require follow-up!!!), I asked him about Muro drops and he basically just said "Yeh, go ahead and use them... indefinitely is OK". So, that's what I've been doing. My diagnosis is ocular rosacea. You should definitely ask your doctor if Muro is for your diagnosis.

I hope you find something that helps.