Someone else may notice a small gap between your eyelids while you sleep, or you may wake with a dry, gritty eye. These signs have other possible causes, so they cannot confirm the diagnosis by themselves.
Symptoms and possible complications
Morning dryness, redness, a scratchy sensation, light sensitivity or blurred vision can occur when the eye’s surface is exposed overnight. Persistent exposure can damage the cornea. The American Academy of Ophthalmology (AAO) explains that severe exposure can lead to corneal scarring and vision loss.
Seek prompt eye care for significant eye pain, a very red eye, light sensitivity or a change in vision. Sudden facial droop or weakness, particularly with arm weakness or speech difficulty, may signal a stroke: call emergency services immediately.
Why might the eyelids stay open?
Possible causes include facial nerve weakness, eyelid injury or scarring, previous surgery, or a condition that changes eyelid position or causes the eyes to protrude, such as thyroid eye disease. Some people have no obvious cause. An eye examination helps distinguish incomplete closure from other causes of dry eyes.
How is it diagnosed?
An eye-care professional can ask about symptoms and medical history, examine eyelid closure and use a slit lamp or a dye test to look for surface damage. If someone has observed your eyelids during sleep, sharing that observation can help. Your clinician may investigate an underlying facial nerve or thyroid problem when appropriate.
Treatment and eye protection
Treatment depends on the cause and severity. An eye clinician may recommend lubricating drops or a nighttime ointment, a moisture chamber, or another way to protect the eye. Ointments can temporarily blur vision. Follow the clinician’s advice before using tape or any device near the eye; unsuitable products or techniques can irritate or injure it.
More severe or persistent cases may require specialist procedures to improve eyelid closure. Do not delay an examination if symptoms persist or your vision changes.
Frequently asked questions
Can you sleep with your eyes partly open?
Yes. The gap may be small, and a person may not know it is present.
Does waking with dry eyes always mean lagophthalmos?
No. Dry eye has several causes. An eye-care professional can identify the likely reason.
Is it always harmless?
No. Persistent exposure may damage the eye’s surface, so ongoing symptoms should be assessed.