Eye Health More Eye Issues & Safety Is It Safe to Sleep With Your Eyes Open? By Troy Bedinghaus, OD linkedin Troy L. Bedinghaus, OD, board-certified optometric physician, owns Lakewood Family Eye Care in Florida. He is an active member of the American Optometric Association. Learn about our editorial process Troy Bedinghaus, OD Medically reviewed by Medically reviewed by Johnstone M. Kim, MD on July 09, 2020 Johnstone M. Kim, MD, is board-certified in ophthalmology. He's a practicing physician at Midwest Retina in Dublin, Ohio and previously served as a full-time faculty member at the Wayne State University School of Medicine and the Kresge Eye Institute in Detroit, Michigan. Learn about our Medical Review Board Johnstone M. Kim, MD on July 09, 2020 Print Table of Contents View All The Role of Your Eyelids Causes of Nocturnal Lagophthalmos What Nocturnal Lagophthalmos Feels Like Treatment of Nocturnal Lagophthalmos Did someone tell you that you sleep with your eyes open? Chances are, you had no idea your eyes aren't completely closed while you are asleep. If you sleep with your eyes open, or at least your eyelids only partially closed, is called nocturnal lagophthalmos. It tends to be rather common in young children. However, they often outgrow the condition. It is also common in older people due to changes in the eyelid tissue. Nocturnal lagophthalmos can also occur during the day. Patients with this condition do not have a full blink, so there is always a part of the eye that does not receive enough tear lubrication. When your eyelids do not fully close, your eyes are exposed to the open atmosphere. Because your eyelids help lubricate the surface of your eyes, your eyes begin to dry out significantly. You may wake in the morning feeling like your eyes are dry, tired, and/or itchy. Verywell / Gary Ferster The Role of Your Eyelids Your eyelids provide a barrier, allowing tears to lubricate the surface of your eyes. Along with nutrients, tears have natural antibiotics to help kill viruses and bacteria. When the barrier is broken, your eye becomes exposed to the outside environment and the tear film begins to evaporate almost immediately. When this occurs night after night, your eyes can become inflamed and the cornea and conjunctiva may form dry spots, ulcers, and even scarring if not treated. Causes of Nocturnal Lagophthalmos It may sound strange, but nocturnal lagophthalmos is actually considered a form of facial paralysis; it involves the orbicularis muscle in the eyelid and may be temporary or permanent. It can be caused by several things, including Bell's palsy, infection, stroke, surgery, and trauma. Lagophthalmos may also develop after undergoing upper blepharoplasty. Blepharoplasty is a procedure used to remove excess skin on the upper eyelid (suprapalpebral hooding) that often occurs with aging. The procedure can help you see better as well as look younger. However, if too much upper eyelid skin is removed, the lagophthalmos may develop. What Nocturnal Lagophthalmos Feels Like Obviously, unless you video yourself while sleeping, you won't realize you sleep with your eyes open until you experience symptoms. If you suffer from nocturnal lagophthalmos, you may awaken with dry eye symptoms such as feeling like something is in your eye, redness, pain, and blurry vision. Some people also complain of increased light sensitivity. Lagophthalmos is actually often confused with chronic dry eye syndrome, as symptoms closely mimic each other. Your eye doctor will be able to determine if you are suffering from dry eye syndrome by conducting a comprehensive eye exam. Your tear production can be measured to make sure your eyes are producing adequate moisture. The Schirmer test is used to measure your tears. During the test, small strips of paper are placed under your lower eyelids. After a few minutes, your doctor will measure how much of the strip was soaked up by your tears. Other tests can be used to determine the quality of your tears. Special dyes in eye drops can be instilled in your eyes to determine the surface condition of your eyes. Staining patterns on the corneas will determine the amount of time it takes your tears to evaporate. Treatment of Nocturnal Lagophthalmos Treatment usually involves artificial tear eye drops given several times per day along with the installation of a bland eye gel or ointment at bedtime. Ointments may be applied to the cornea at bedtime in severe cases. Because ointments can cause vision to blur, most people can only tolerate them during sleep. To prevent the eyelid from opening at night, medical-grade hypoallergenic tape may be gently applied to the eyelid to keep it closed. A mask worn over the eyes may also help. Your doctor may also recommend that you turn down or turn off ceiling fans. In severe cases, a gold weight may be applied to the outside of the eyelid or surgically implanted inside the eyelid. The gold weight is compatible with the body and uses nature’s gravity to help provide a full blink. Another more recent treatment option is scleral contact lenses or corneal gas permeable lenses which cover the cornea and create a more natural and protected environment on the surface of the eye. A Word From Verywell Don't be afraid to ask your doctor if you might be experiencing lagophthalmos. Sometimes it is difficult to know, as your eyes may be dry due to other causes such as dry eye syndrome. However, the effects of sleeping with open eyes can be severe. Treatments could significantly improve your quality of life. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Hartford J, Trief D. American Academy Of Ophthalmology. Exposure keratopathy. Updated March 2019. Hamedani A, Gold D. Eyelid dysfunction in neurodegenerative, neurogenetic, and neurometabolic disease. Front Neurol. 2017;8:329. doi:10.3389/fneur.2017.00329 Vásquez L, Medel R. Lagophthalmos after facial palsy: current therapeutic options. Ophthalmic Res. 2014;52(4):165-9. doi:10.1159/000365519 Yang P, Ko A, Kikkawa D, Korn B. Upper eyelid blepharoplasty: evaluation, treatment, and complication minimization. Semin Plast Surg. 2017;31(1):51-57. doi:10.1055/s-0037-1598628 Kim K, Graham A, Li W, Radke C, Lin M; Human lacrimal production rate and wetted length of modified Schirmer's Tear Test strips. Trans. Vis. Sci. Tech. 2019;8(3):40. doi:10.1167/tvst.8.3.40 Harthan J, Shorter E. Therapeutic uses of scleral contact lenses for ocular surface disease: patient selection and special considerations. Clin Optom (Auckl). 2018;10:65-74. doi:10.2147/OPTO.S144357 Additional Reading Lawrence, Scott D. and Carrie L. Morris, MD. Pearls. Lagophthalmos Evaluation and Treatment. American Academy of Ophthalmology, 2008.