How to Create the Perfect Nighttime Routine for Dry Eye Relief

Dry Eye disease (DED) affects millions of people worldwide and can cause significant discomfort - even affecting quality of life. It is important to take measures during day-to-day activities to mitigate symptoms. However, establishing a nighttime routine can  be tremendously beneficial for symptomatic relief as well as even include some more targeted and long-term management strategies that will help even more in the long-term. Here is an example (and some tips!) of an ideal nighttime dry eye routine.

1. Remove makeup and debris thoroughly: This prevents makeup from clogging meibomian glands (1,2), crucial for optimal ocular lubrication. Using a gentle micellar solution or hypoallergenic cleanser can be ideal for this.
   
2. Cleanse the eyelids and eye area well: Maintaining good eyelid hygiene is essential to prevent debris, bacteria, mites or excess oils from clogging the meibomian glands or contributing to eye and eyelid inflammation. Patients with significant amounts of eyelid inflammation are more likely to have less tear stability, higher levels of meibomian gland damage and higher tear evaporation rates (3). Antimicrobial facial or eyelid cleansers are great options here, as well as eyelid cleansing wipes or antimicrobial eyelid sprays for more microorganism reduction.
   
3. Use a warm compress or warming mask for 10 minutes before bed (4): The most common cause of chronic dry eye is meibomian gland dysfunction (MGD). An eyelid warming mask is one of the mainstays of treatment for this condition. The direct heat from the mask stimulates the meibomian glands in your eyelids. After the ten minute heat period is completed, a gentle lid massage for a few minutes can help even more to stimulate the glands and push the oils (meibum) into the tear film. In addition to being a targeted and long-term treatment strategy, the warming mask is extremely relaxing for nighttime use to promote more restful sleep!
   
4. Use a good quality artificial tear drop: Following the warming mask it is a great idea to give your eyes a soothing eye drop. There are many available options for drops, but in general, the best quality drops will be preservative-free formulas without additives or medications in them (5). Avoid anything that says it is redness-relieving or harshly preserved as these drops may irritate your eyes as opposed to being calming or soothing. For more severe cases of dryness, you may want to consider a gel or ointment formulation for a longer duration of action overnight. Ask your optometrist for suggestions.
   
5. Limit screen time before bed: Prolonged screen use is one of the activities that exacerbates dry eyes as we don’t blink as often or as fully while using our computers, tablets or smartphones (6). Ideally, limit screen use so as not to worsen dry eye symptoms before bed. 
   
6. Use a humidifier: A humidifier in your bedroom may be helpful to promote a more moist environment during sleep hours; they can also help to prevent excessive evaporation and moisture loss from the eye’s surface overnight (7). 
   
7. Limit use of ceiling fans/air flow: Ceiling fans can dry your eyes more during sleep hours, especially if you suffer from nocturnal lagophthalmos. If possible, turn off ceiling fans or redirect the air flow from vents or fans away from your bed to limit air flow to your face while sleeping (8).
   
8. Wear moisture chamber goggles to bed: For patients with severe dryness, a moisture retaining sleep mask or goggle worn during sleep hours can be extremely helpful (9). This keeps the environment around your eyes controlled during sleep hours and minimizes moisture evaporation in the ocular region. For patients with nocturnal lagophthalmos, this is an even more important measure to maintain ocular hydration. 

Conclusion

Dry eye is chronic and doesn’t end when we sleep. Following this list of nighttime routine tips can help you achieve around-the-clock management for your condition, which will in turn help your eyes stay hydrated and more comfortable even during the day. As always, ask your eye care practitioner for suggestions or more specific explanations on any of these tips for a more personalized plan.

References:

1. Okura, Masako, et al. "New Eye Cleansing Product Improves Makeup‐Related Ocular Problems." Journal of ophthalmology2015.1 (2015): 831628. 
2. Kudasiewicz-Kardaszewska, Agnieszka, Jane M. Grant-Kels, and Andrzej Grzybowski. "Meibomian gland dysfunction and blepharitis: A common and still unsolved ophthalmic problem." Clinics in Dermatology 41.4 (2023): 491-502. https://www.sciencedirect.com/science/article/abs/pii/S0738081X23000846
3. McCann, Louise C., et al. "Tear and meibomian gland function in blepharitis and normals." Eye & contact lens 35.4 (2009): 203-208. https://journals.lww.com/claojournal/abstract/2009/07000/tear_and_meibomian_gland_function_in_blepharitis.9.aspx
4. Lee, Gladys. "Evidence-Based Strategies for Warm Compress Therapy in Meibomian Gland Dysfunction." Ophthalmology and Therapy 13.9 (2024): 2481-2493. https://link.springer.com/article/10.1007/s40123-024-00988-x
5. Mikha, K. N., et al. "Can the choice of artificial tears harm patients? A narrative review with an overview of the Nordic market." Acta Ophthalmologica (2025). https://onlinelibrary.wiley.com/doi/full/10.1111/aos.17455
6. Mehra, Divy, and Anat Galor. "Digital screen use and dry eye: a review." Asia-Pacific journal of ophthalmology 9.6 (2020): 491-497. https://www.sciencedirect.com/science/article/pii/S216209892300155X
7. Yeo, Sharon, and Louis Tong. "Coping with dry eyes: a qualitative approach." BMC ophthalmology 18 (2018): 1-9.  https://link.springer.com/article/10.1186/s12886-018-0671-z
8. Sharma, Anushree, and Holly B. Hindman. "Aging: a predisposition to dry eyes." Journal of ophthalmology 2014.1 (2014): 781683. https://onlinelibrary.wiley.com/doi/full/10.1155/2014/781683
9. Korb, Donald R., and Caroline A. Blackie. "Using goggles to increase periocular humidity and reduce dry eye symptoms." Eye & Contact Lens 39.4 (2013): 273-276. https://journals.lww.com/claojournal/abstract/2013/07000/using_goggles_to_increase_periocular_humidity_and.4.aspx

Contributors:

Sarah Farrag, OD

Dr. Sarah Farrag is originally from Halifax, Nova Scotia, and is happy to be practicing optometry in her hometown. She graduated with honors from the University of Waterloo Doctor of Optometry program in June 2015. In addition to routine optometric care, Dr. Farrag also facilitates an advanced dry eye clinic offering specialty consultation and treatment for severe dry eye.