If you have painful eyes in the morning, there are several conditions that could be responsible for the eye pain. These conditions are all made worse overnight and then are most painful in the morning.
Types of Eye Pain
There are multiple types of eye pain that can be experienced. If the eye pain is sharp and intense, it is likely due to an issue on the cornea.
If the eye pain feels deeper, like a boring sensation, it is more likely that the eye pain is due to the ciliary muscle which controls focusing.
However, if the eye pain is focused in an area around the eye, the cause can be related to the skin and muscles around the eye and not within the eye.
If pain is worse in the morning, it is likely that it is due to pain from the cornea on the front of the eye.
Pain on the Cornea
The cornea is highly sensitive and has many free nerve endings within it that can sense pain from contact or damage to the cornea.
The free nerve endings in the cornea make it sensitive to even small changes that can be perceived as pain.
This pain is usually described as very intense, sharp, or shooting pain. If the cornea is in constant pain, it may become extremely severe and progress to a point of intolerable pain.
More frequently, the pain on the cornea is brief but very painful for a short period of time.
Morning Eye Pain
Eye pain in the morning is typically due to a corneal problem that is worsened at night. The cornea can have a defect that is opened at night or can become dry while sleeping.
Any of these conditions can lead to pain in the morning that is much worse than the rest of the day.
Recurrent Corneal Erosions
The condition most often associated with eye pain in the morning is called recurrent corneal erosion.
In recurrent corneal erosion, there is an area of the cornea which has been damaged, such as a being scratched, and it is unable to heal properly.
Each day, the cornea attempts to heal the damaged area but then the eyelids become attached to the newly healed cornea at night and upon waking, the healed area is ripped open again.
These recurrent corneal erosions are not easily treated without intervention and pay require a bandage contact lens, a lens made from stem cell tissue, or steroid eye drops.
Any recurrent corneal erosion can also leave the cornea vulnerable to infection and is typically treated with an antibiotic eye drop to prevent an infection.
Dry Eye at Night
While dry eye can cause irritation and discomfort throughout the day, there are specific types of dry eyes which may cause pain that is worse in the morning.
If the eyelids do not close entirely, there is a small band of the cornea which is exposed all night while sleeping.
This area can become extremely dry and then cause pain in the morning when blinking restores the tears to that area.
A sleep mask can be helpful to ensure that the eyelids close entirely, or if needed the eyelids can be taped down to prevent the exposed cornea.
Like other dry eye conditions, artificial tears or lubricating drops may be used to help keep the eyes moist throughout the day.
Determining the Cause of Morning Eye Pain
If you experience eye pain in the morning, it is important to schedule an appointment with your eye doctor to explore anything that may be causing the pain.
Since these conditions are both treatable, it is helpful to determine the cause of the eye pain early and allow the treatment to have more time to be effective.