Why Do Your Eyes Feel Dry and Gritty?

Many people visit the eye doctor with a common complaint: "I feel there's sand in my eyes when I wake up in the morning." Along with this sensation, eyes may hurt, itch, burn, or feel gritty—as if a small particle is stuck in the eye.

Some people with these complaints may also have difficulty opening their eyes or can be sensitive to light.

By the time you head to your doctor, you may already have purchased several types of over-the-counter eye drops. These drops may provide some short-term relief or they may do nothing more than sting or burn a little.

If your eyes feel dry and gritty, you should see a doctor to find out if the cause could be a medical condition.

This article will explain the potential causes of gritty eyes, plus some remedies.

Dry Eye Syndrome

Dry eye syndrome is one of the most common causes of a gritty feeling in the eyes. Dry eye syndrome often causes a sandy, gritty sensation in the morning that usually gets worse throughout the day.

Dry eyes can trigger some irritating symptoms.

Among them:

• Your eyes may burn or itch.
• Your vision may fluctuate.

Artificial tears, sold over the counter, can be a great start to treating dry eyes. Ask your healthcare professional or eye doctor to make a recommendation.

Your doctor may recommend that you use an eye gel or ointment.

Nocturnal Lagophthalmos

Your healthcare provider may ask you if anyone has ever told you that you sleep with your eyes open.

It may sound impossible, but a condition called nocturnal lagophthalmos causes people to sleep with their eyes partially open.

Your eyes can dry out considerably when you don't blink. Then an inflammation, called keratitis, can develop. This can cause light sensitivity and a strong sandy, gritty sensation in your eyes upon awakening in the morning.

Lagophthalmos has several causes:

• It can be an anatomical issue in children, who usually outgrow it quickly.
• It could stem from cosmetic eyelid surgery. The skin may have been raised or tightened too much, preventing a "full blink" or a tight close.
• It could be due to proptosis, which results from thyroid eye disease.

Eye drops may not be up to the task of treating nocturnal lagophthalmos. Thicker eye ointments used at bedtime may be a better choice to reduce symptoms and speed healing. If your doctor recommends that you use thicker eye drops, you should know that these can temporarily blur vision when you put them in.

Another choice can be to use surgical tape to keep your eyes closed while you are sleeping.

Blepharitis

Blepharitis is a group of conditions that affect the eyelashes, eyelids, and eyelid glands. Blepharitis is commonly caused by bacteria.

The bacteria can grow because of:

• The natural process of aging
• A lack of good hygiene
• Plugged eyelid glands, which can cause meibomian gland dysfunction, or eye styes

Blepharitis tends to cause eye redness and inflammation. People with blepharitis may wake up in the morning with crusty eyelids. Sometimes, dried mucus can fall into the eye, causing irritation or a sandy, gritty sensation.

Floppy Eyelid Syndrome

Floppy eyelid syndrome (FES) is a relatively uncommon condition characterized by loose upper eyelids that easily turn inside out. Some people with FES also have obstructive sleep apnea.

Treatment for FES often includes artificial tears to reduce irritation and an antibiotic if signs of infection are present. Using tape or an eye shield to keep the eyelids closed while sleeping may help keep the eyes from becoming dry.

Environment

A gritty sensation in your eyes can be caused by your home or work atmosphere. Dry air is a likely culprit, either from an air conditioner or furnace that runs frequently. So too is heavy smoking.

Your eyes could feel gritty from air pollution if you live or work near a factory.

Your healthcare professional or eye doctor should be able to help you determine if environmental factors are contributing to or causing your dry and gritty eyes.

Medications

Some oral prescription medications may cause your eyes to feel dry and sandy. For example, some antidepressants and antihistamines can be associated with this side effect. Even some over-the-counter medications taken by mouth can dry out the eyes.

Ask your healthcare provider or eye doctor to review your current medications to determine if any are responsible for your symptoms.

Age

It can be inevitable: Many people develop a sense of grittiness in their eyes as they age. Tear production tends to decrease and become less efficient as people grow older.

And a decrease in skin elasticity can prevent eyes from fully closing.

Menopausal women tend to experience dry eyes along with other symptoms due to changing hormones.

Diagnosis

It can be annoying to feel as though something is in your eye. If you wake up more than once with a sandy, gritty feeling in your eyes, see your healthcare professional or eye doctor.

Be prepared to answer the following questions:

• Do you sleep with your eyes partially open?
• Do you sleep under an air vent or ceiling fan?
• Do your symptoms worsen upon awakening?
• Do your symptoms get better as the day goes by?
  

Your doctor may examine your eyes under a slit lamp to look for signs of dryness or other signs of inflammation, such as keratitis.

They may instill a special dye or stain to see where on your eye the dryness or inflammation is occurring. The location can provide clues as to the underlying cause of the symptoms and help guide the right treatment.

Summary

Diagnosing the cause of dry, gritty eyes is important. You shouldn't feel like you have to tolerate this problem—there are solutions. Your doctor may consider dry eye syndrome, nocturnal lagophthalmos, blepharitis, and floppy eyelid syndrome. Air quality, some medications, and the aging process can cause eyes to feel dry, too.