You might have heard the threat, “you better sleep with your eyes open” before and thought it was just a turn of phrase. It is estimated that 20% of individuals, however, sleep with their eyes open periodically throughout the night! The condition is called nocturnal lagophthalmos, and up to 20% of individuals are affected by it.

Those with nocturnal lagophthalmos rarely sleep with their eyes wide open. In most cases, the lids will close most of the way, but not completely. Even a small opening in the eyelids is problematic however, and can cause the eyes to become chronically dry. This chronic dryness can lead to scratches on the eye, corneal ulcers, corneal abrasions, and exposure to keratopathy.

Symptoms

If your eyes are not closing all the way at night, you can experience the following symptoms:

• redness
• blurred vision
• irritation or a burning sensation
• scratchiness
• sensitivity to light
• feeling as if something is in the eye or rubbing against it
• poor sleep quality

Most of the individuals with nocturnal lagophthalmos are unaware that they sleep with their eyes open! If you are suffering from any of the symptoms below, have a partner, family member, or friend check on your eyes while you are sleeping. Your eye doctor will also be able to help diagnose your condition based on an in person evaluation.

Cause of Sleeping With Your Eyes Open

There isn’t always a reason for nocturnal lagophthalmos, for many, it is genetic. There can be underlying conditions that can cause you to sleep with your eyes open though, which is why you should consult a doctor if you suffer from any of the symptoms above.

Causes include:

• Damage to the eyelid muscles via infection, injury, or inflammation
• Born with eyelids that don’t close all the way
• Bell’s palsy, stroke, or tumor that has paralzyed a portion of the facial nerves
• Graves disease (which causes the eyes to bulge forward)
• Autoimmune diseases, such as Guillain_Barre syndrome
• Surgery was done to the eyelids (in most cases blepharoplasty)

Treatment Options

There are a multitude of ways to treat nocturnal lagophthalmos, ranging from easy to more invasive. Your eye doctor will be able to help you determine which treatment options will best fit your unique case.

• Treat the underlying condition (if applicable)
• Use eye drops or eye ointment at night
• Tape the eyelids shut with medical tape
  • Your eye doctor will help you know the best way to go about this
• Undergo surgery to change how the eyelid moves
• Undergo surgery to add weights to the eyelids to help them close

If you suffer from nocturnal lagophthalmos, our experienced eye doctors at Mill Creek Family Eye Center will be able to help you diagnose and treat your condition.