The sclera, or whites of your eyes, are filled with tiny blood vessels. If these blood vessels become dilated or swollen, red eyes will result, especially upon waking.
Red eyes upon waking can often be alleviated by changing lifestyle habits. It’s important, however, to distinguish between nonemergency causes of bloodshot eyes and more serious conditions that have red eyes as a symptom.
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Nonemergency causes
There are plenty of reasons for red eyes upon waking that aren’t considered serious.
Computer vision syndrome
Staring at digital devices for 2 or more hours in a row can cause eye redness. If you do this late at night, you may wake up with red eyes every morning.
Computer and digital device use strains the eyes significantly because you tend to blink less when staring at screens. This, in turn, reduces the amount of moisture in the eyes, causing redness.
Eyestrain
Like computer vision syndrome, other causes of eyestrain can result in morning eye redness. These include driving long distances at night or trying to read in dim lighting.
Lack of sleep
Everyone burns the midnight oil now and then, and red eyes upon waking are often a result. Not getting enough sleep reduces the amount of lubrication and oxygen in the eyes, causing temporary redness to occur.
Dry eye syndrome
During sleep, your eyes may reduce their production of lubricating tears. This can lead to dryness and redness upon waking. In people with dry eye syndrome, red eyes in the morning may be more pronounced for this reason.
Drinking alcohol to excess
If you have one too many the night before, you may wake up with red eyes. That’s because alcohol is a diuretic that dehydrates the body, including the eyes.
Environmental irritants
Air pollution such as dust, cigarette smoke, ash from fire, and car exhaust, can irritate the eyes, causing them to turn red. Dry air that lacks humidity can also irritate eyes.
Allergies
Pollen, dust mites, pet dander, and other allergens can cause itching, redness, and tearing. Whether your allergies are seasonal or year-round, taking an over-the-counter antihistamine may help.
Serious conditions
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When red, bloodshot eyes in the morning are the symptom of a medical condition, there are typically other symptoms you can look out for as well.
Symptoms that should always trigger medical attention include:
- pain in the eye
- intense red or pink color that doesn’t dissipate for over a week
- blurry or double vision
- changes in vision
- sensitivity to light or halos around light
- nausea and vomiting
- eye discharge
Some of these symptoms are associated with the following conditions:
Uveitis
The uvea is the eye’s middle layer and the part of the body that supplies the retina with blood. People with uveitis have swelling of the uvea.
There are many causes for this condition, which causes severe red eyes as well as pain, blurriness, dark floaters (floating spots in your vision), and sensitivity to light.
It can become a serious threat to your vision and requires a doctor’s care.
Sleep apnea
Sleep apnea causes sudden fluctuations in blood pressure and oxygen levels, which can affect the blood vessels in the eyes.
Inflammation and redness may result. Over time, retinal damage can also occur from this condition.
If you have other symptoms of sleep apnea, such as headaches, irritability upon waking, or forgetfulness, see your doctor.
Nocturnal lagophthalmos
This condition causes your eyelids to not close completely during sleep. It may be a symptom of serious conditions that require a doctor’s care. These include Bell’s palsy and autoimmune diseases.
In addition to red eyes in the morning, symptoms of nocturnal lagophthalmos include pain, irritation, watery eyes, and a gritty feeling in your eye that feels like a foreign body.
Subconjunctival hemorrhage
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This condition is caused by a broken or leaking blood vessel in the eye. It can be caused by a number of things, including an injury to the eye or intense coughing.
If you’ve had an eye injury, see your doctor to rule out serious complications. Subconjunctival hemorrhage doesn’t hurt, but it may cause the eye to feel scratchy or full. It usually clears up on its own, without treatment.
Blepharitis (eyelid inflammation)
Blepharitis may be caused by a wide range of irritants, bacteria, fungi, and viruses. It may also be caused by several underlying conditions.
In addition to red and inflamed eyes upon waking, blepharitis can cause itching, sensitivity to light, and crusts on the upper eyelids.
Since these symptoms can signal a serious infection, see your doctor immediately to determine the root cause. Steroidal or lubricating eye drops are often prescribed for the treatment of blepharitis. Antibiotics may also be prescribed.
Conjunctivitis (pink eye)
Conjunctivitis is an eye inflammation that can be bacterial, viral, or allergic. It causes redness, itching, pain, and oozing in one or both eyes. It can also cause your eyelashes to crust over, making it hard to open your eyes in the morning.
If you suspect that you have conjunctivitis, see your doctor. Bacterial conjunctivitis is treated with antibiotics. Viral conjunctivitis is treated with warm compresses and lubricating eye drops.
Acute glaucoma
Acute glaucoma can occur upon waking or during the day and is caused by a sudden, rapid increase in eye pressure.
It’s typically accompanied by pain. It’s a dangerous threat to your eyesight, so if you believe you have it, seek immediate medical attention.
Rheumatoid arthritis
Rheumatoid arthritis (RA) is an autoimmune condition that causes inflammation in the body’s tissues, including the tissues of the eye’s outer layer. Red, dry eyes often result.
If red eyes are accompanied by RA symptoms such as joint pain, weakness, unintended weight loss, or flu-like symptoms, see your doctor.
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