When you wake up in the morning and look in the mirror, seeing red eyes staring back at you isn't a pretty sight. Waking up with red eyes is usually a sign your eye health is compromised, but the reasons can vary from mild to severe.
"Many of the causes for morning redness can be easy to address, but some can be slightly more problematic," says Michelle Andreoli, MD, an ophthalmologist and clinical spokesperson for the American Academy of Ophthalmology.
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Here, Dr. Andreoli explains what could be causing your red eyes in the morning and how to treat it.
1. You Have Sleep Apnea
Sleep apnea is a common sleep disorder that causes your breathing to stop and restart while you sleep, according to the Optometrists Network. Symptoms can include loud snoring and excessive tiredness during the day, per the Mayo Clinic. It can lead to problems with your physical health and affect your eyes.
"The single most common thing I see in my practice is relating to patients who have obstructive sleep apnea and wear a CPAP machine," Dr. Andreoli says.
CPAP (continuous positive airway pressure) therapy helps you breathe during sleep by supplying steady air pressure through a mask or nosepiece.
"Patients who snore tend to not close their eyes all the way in their sleep. CPAP machines blow air up their eyelids all night long, and the eyes tend to get very dry while they sleep," Dr. Andreoli says.
Fix it: Dr. Andreoli says this can be easily fixed by using a lubricating ointment at bedtime and when you wake up. You'll apply a small amount of ointment on the inside of your lower eyelid. This will help lubricate the eyes and prevent the CPAP machine from drying them out and causing redness.
Try Systane Nighttime Lubricant Eye Ointment ($13.47, Amazon; $14.48, Walmart) or Refresh Lacri-Lube Lubricant Eye Ointment ($15.97, Amazon; $15.99, Walgreens).
2. You Have Dry Eye Syndrome
Dry eye syndrome is when your eyes don't make enough tears to stay wet, according to the National Eye Institute. Symptoms of dry eye are a stinging feeling in your eye, red eyes, sensitivity to light and blurry vision. Dr. Andreoli explains this condition can worsen at night if you sleep with a fan on overnight. It can also worsen depending on what position you sleep in.
"A lot of side-sleepers will sleep with their eyes open a small amount and that will make your eyes very dry during sleep," she says. "If you are waking up with dry eyes, your eyes are going to be very red."
Dry eye syndrome can affect anyone, but you're more likely to have it if you are at least 50 years old, wear contact lenses, are vitamin A-deficient or have an autoimmune disease like lupus, per the National Eye Institute.
Fix it: If you are waking up with dry eyes, Dr. Andreoli encourages you to make an appointment with your local ophthalmologist to get to the bottom of it. Home remedies can include using a lubricating ointment before bed (such as those listed above) and washing your eyelids with a mild skin soap and hot water before going to sleep.
3. You Have Conjunctivitis
Conjunctivitis, commonly known as "pink eye," can cause your eye to turn pink or red. Waking up with crusty eyes is a telltale sign of pink eye, along with swelling, pus and itching, per the Centers for Disease Control and Prevention (CDC). It's typically caused by viruses, bacteria or allergens that get into the eyes and is usually more common in kids than adults.
Bacterial and viral conjunctivitis are highly contagious and can easily spread from person to person. If you do suspect you have pink eye, the American Academy of Ophthalmology suggests these tips to stop it from spreading or re-infecting yourself:
- Use a clean towel or tissue every time you wipe your face and eyes.
- Wash your hands often.
- Try not to touch your eyes. If you do, wash your hands immediately.
- Do not use eye makeup while your eyes are infected. Replace your makeup if you have an eye infection.
- Clean your contact lenses.
Fix it: Pink eye can often be treated with home remedies and usually heals on its own. Treating it also depends on what kind of pink eye you have. Per the Mayo Clinic, allergic conjunctivitis can be treated with antihistamines and bacterial conjunctivitis can be treated with antibiotic eye drops. Viral pink eye will go away on its own, but you can place a cool, wet washcloth on your eyes to help soothe them.
4. It's Your Allergies
Seasonal allergies can be blamed for several symptoms, including coughing, sneezing, congestion, itchy eyes and bloodshot eyes, per Mount Sinai. If you have allergies, your eyes will become swollen and irritated when exposed to allergens like pollen, dust, mold and pet dander.
Dr. Andreoli explains when you're allergic to something, the eyelashes get oil-coated and likely sticky. When you go to sleep, the allergens that are stuck to the eyelashes then go into the eyes, and can make them red and irritated. If allergies are the main culprit of waking up with red eyes, the primary symptom to look for is itchiness.
"I typically tell my patients that where there is allergy, there is itch," Dr. Andreoli says. "We don't blame allergies unless there is itching."
Fix it: Dr. Andreoli suggests using a mild face soap to scrub the eyelids and lashes before bed and then again right when you wake up . "This will significantly improve allergic eye disease," she says.
5. You Have Eyelid Acne
If the skin around your eyes is red in the morning, the culprit might be eyelid acne, Dr. Andreoli says (yes, even your eyes can experience breakouts).
People who have chronic acne or rosacea can also have irritated eyelids, she says. This can come from the buildup of oil, dead skin and hair cells. "Where there is acne on the face, there are acnes on eyelids. We call it rosacea, but it is in the acne family," Dr. Andreoli says.
According to the Mayo Clinic, rosacea of the eyes (also known as ocular rosacea), is when the eye becomes inflamed, causing redness, itchiness and a burning sensation. It's a condition that typically affects adults between ages 30 to 50.
Fix it: Ocular rosacea does not have a cure, but it can be managed with an eye-care routine. Dr. Andreoli recommends treating this with quality skin-care, just like you would on your skin to relieve irritation.
Before bed, wash your face (including your eyelids) with a gentle cleanser, such as Cetaphil Hydrating Gentle Skin Cleanser ($15.59, Amazon; $22.95, Walmart) or CeraVe Hydrating Cleanser Bar ($6.45, Amazon; $5.26, Walmart).
6. You Have Glaucoma
In rare cases, having bloodshot eyes when you wake up could be a sign of glaucoma. Acute angle-closure glaucoma is a serious condition caused when the eye pressure gets very high, making the eyes red and causing severe pain, Dr. Andreoli explains. Eye pressure measures the fluid pressure inside of the eyes. It's similar to measuring blood pressure, according to the American Academy of Ophthalmology. Glaucoma causes high eye pressure, damaging the optic nerve and causing potential vision loss.
Symptoms of angle-closure glaucoma can include headaches, eye pain, nausea and blurred vision, per the Glaucoma Research Foundation.
If untreated, acute angle-closure glaucoma can make you go blind, so it's crucial to be diagnosed by an ophthalmologist.
Fix it: Acute angle-closure glaucoma is considered a medical emergency. If left untreated, there can be permanent damage to your vision. Contact your doctor right away.
7. You've Had a Subconjunctival Hemorrhage
A subconjunctival hemorrhage is when a blood vessel in the eye bursts, creating a pool of blood in the white part of your eye, per the Mayo Clinic. It looks scary and may have you concerned, but as Dr. Andreoli explains, these can occur without any serious harm to your eyes.
"If you rub your eye, blink too hard, sneeze or itch your eyes during sleep, you can sheer the blood vessels on the surface of the eye," she says. The most obvious sign that you've had a subconjunctival hemorrhage is waking up with one bloodshot eye, but there is no pain or change in vision.
"It looks terrible but does not affect the health of the eye at all," Dr. Andreoli says. "It's similar to getting a bruise. It looks worse than it actually is."
Fix it: A subconjunctival hemorrhage will go away on its own within two weeks without any treatment, Dr. Andreoli says. If your eyes are feeling irritated, you can use eye drops or artificial tears to soothe them. Try Blink Tears Lubricating Eye Drops ($10.29, Amazon).
When to See a Doctor About Red Eyes
If you're waking up with red eyes every day, it's time to call your doctor. Red eyes accompanied by eye pain or other concerning symptoms like vision loss should be addressed immediately in order to rule out (or diagnose) glaucoma.
"Any red eye can be problematic until you know what it is," Dr. Andreoli says. "Our eyes are relatively defenseless. They can turn red, tear up and vision can change, but that's all the warning you get. Many of these things are easily treated as long as we know what they are."
- Optometrists Network: "Can Sleep Apnea Affect Your Eyes?"
- Mayo Clinic: "Sleep Apnea"
- National Eye Institute: "Dry Eye"
- Centers for Disease Control and Prevention: "Conjunctivitis (Pink Eye)"
- American Academy of Ophthalmology: "Conjunctivitis: What Is Pink Eye?"
- Mount Sinai: "Allergic Conjunctivitis"
- Glaucoma Research Foundation: "What is Angle-Closure Glaucoma?"
- Mayo Clinic: "Subconjunctival Hemorrhage (Broken Blood Vessel in Eye)"
Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.