Stop Waking Up With Burning, Red Eyes

February 27, 2025

Shannon Bream awoke to an assailant stabbing her eyes. But the horrific pain didn't come from a murderous intruder in the Fox News host's bedroom...

It was all happening in her eyes... every time she got an hour of sleep.

The pain and resulting sleep deprivation even led her to contemplate ending her own life...
Bream was suffering from dry eye. While the name might sound harmless to some, it's a constant source of pain that disrupts the everyday lives of at least 16 million Americans.

Today, I'm going to discuss why dry eye occurs and who is at risk. Then, I'll give you tips to stop dry eye in its tracks so you won't have to settle for burning, red, watery eyes any longer.

Dry eye refers to a gritty, burning, itchy sensation in the eyes. It causes your eyes to water and become red. Sometimes it can make your eyes feel like they're glued shut in the morning. It can also make your eyes feel strained and more sensitive to light.

The condition comes from a disruption to the thin, clear, moisturizing coating over the eye. This is the tear film, and it spreads out over your eye each time you blink.

Your tear film is more complex than you'd think...

Here's a breakdown of the three layers shown above:

The mucous layer is produced by the meibomian glands under your eye. This layer sits closest to your eye. It keeps the next layer from evaporating.

The watery layer is produced by the lacrimal gland above your eye. This layer is sandwiched between the mucous layer and the next one, called the lipid layer.
The lipid (fat) layer is produced by the conjunctiva and cornea. This is the outermost layer of the tear film.

Thanks to its three layers, your eyes stay moist and lubricated. And any problems with any of the four eye structures shown above can disrupt the moisture balance on the surface of your eyes.

Dry eye has a bevy of possible causes... one being something that happens to all of us: aging.

Typically in our 50s, tear production diminishes... and enter: dry eye. Aging can shrink the meibomian glands. So they make less meibum, the oily substance making up the protective mucous layer I mentioned earlier.

Also, hormonal changes – namely, the kind that happen during menopause – put older women at higher risk of developing dry eye. The trouble lies with dropping levels of androgen. This hormone normally helps the lacrimal and meibomian glands produce the oil and fluids your eyes need to make high-quality tears. So declining androgen levels can redden women's eyes.

Aging aside, dry eye can arise from things like...

Other biological changes such as autoimmune disease, inflamed eyelid glands, or allergic eye disease.
Environmental factors like allergies, wind, high temperature, low humidity, high altitude, and air pollution.
Wearing contact lenses and not blinking enough.

Whatever the cause, dry eyes can worsen from just being a nuisance to interfering with your ability to live a normal, comfortable life.

If you're already suffering from this ailment, the right eye drops can help. Here are some tips...

You'll want something with glycerin or carboxymethyl cellulose. Keep in mind these make the drops a bit thicker in consistency, thus making it harder to see after using them. So you'll need to find a type that's comfortable for you.
Get dry-eye formulas only. Itchy or red-eye formulas contain extra chemicals that won't help.
Avoid too many ingredients... the simpler, the better.
Avoid anything with preservatives, especially benzalkonium chloride. This chemical not only causes cell damage, but it also triggers allergic reactions in some folks. You'll find the most preservatives in big bottles, so buy small bottles or single-use packets. Systane lubricant eye drops and Refresh lubricant eye drops are examples of preservative-free ones.
Know that once you open that container, you also open it up to contaminants... The ingredients can degrade due to oxygen entering those bottles and reducing the effectiveness of those drops. Aside from reducing the effectiveness of the drops, a freshly cracked bottle can quickly become a germ factory. A 2022 review found that the cap and the dropper tip (especially if there's dried residue) are primo zones for contamination from microbes that may have been hanging out on your hands or on your eyelids and eyelashes. Some studies showed antibiotic-resistant bacteria hanging out on the dropper tip.
Unless you want to risk an eye infection, always apply your eye drops after washing your hands. Make sure that the only thing the dropper tip comes in contact with is the inside of the cap.
Scribble on the bottle the day you squeezed out that first drop or the date you should chuck the whole thing (like four weeks from the date you open the bottle). Or just buy the single-use, preservative-free vials – they're the safest kind.
Store your eye drops in the fridge if specified on the packaging. Otherwise, keep them in a dark, dry place at room temperature.

Finally, if you tend to wake up with a bad case of dry eye, do what I do and use the thick eye drops at night, right before you go to bed. That thickness allows the moisture to last for longer. Just keep in mind that the consistency can make your vision pretty blurry.

And if thick drops at night along with our other ideas don't work, there's one last thing you could try... using white skin tape to tape your eyes shut at night.

Back in my residency, many elderly women who'd failed everything else often swore by it. They said it really helped but took some getting used to. Just be sure to do one eye at a time and alternate nights.

People also use bubble patches and moisture cups that are meant to keep the eyes from drying out at night. However, most folks will succeed with just thicker lubricants.

P.S. Retirement Millionaire subscribers should check out this past monthly issue where I outlined three ways to prevent dry eyes. Not a subscriber? Click here to get started today.

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Here's to our health, wealth, and a great retirement,

Dr. David Eifrig and the Health & Wealth Bulletin Research Team
February 27, 2025