Red eyes are a general term used to describe irritated, red, and bloodshot eyes, and they occur when the vessels in the surface of the white portion of the eye (sclera) become swollen. In many cases, they are often related with fatigue in the morning, and are typically harmless. However, red eyes in the morning could also indicate other underlying medical conditions. Although it usually doesn’t present with other symptoms, some people may experience vision problems and pain with the condition.

Causes of Red Eyes in the Morning

Red eyes are characterized by the inflammation of small blood vessels, which get congested with blood. Following are some examples of the conditions that cause eye redness in the morning:

• It may develop from fatigue, irritation from an air-borne particulates, or eyestrain.
• Outdoor environmental conditions, such as chemical fumes, smoke, dust, and exposure to harsh weather conditions like bright sunshine or windy days
• Medical conditions like allergies, cold or flu, trauma, bleeding disorders, vitamin B2, B6 or amino acids deficiency
• Eye irritation caused by foreign objects, corneal scratches, eye infection, etc.

• Lifestyle factors such as improper diet, insufficient sleep, excessive alcohol intake, excessive cosmetics, and smoking
• Subconjunctival hemorrhage
• After swimming for long periods of time in chlorinated water
• Improper, or overuse of contact lens
• Other reasons may include inflammation of the iris (iritis), liver or kidney disease, diabetes, high blood pressure, acute glaucoma, glandular fever, and pregnancy.

What Can You Do?

Treatment for red eyes in the morning depends on the underlying cause.

• If you have allergies, it can be remedied with over the counter (OTC) or prescription antihistamines.
• Dry eyes can be corrected with OTC artificial tears.
• In cases where a blood vessel is broken, providing there isn’t any infection or trauma, no treatment is necessary.
• For irritated eyes, try not to rub the eyes with your hands. Use ice packs, or rinse them with cool water instead.

Or you can try the following ways to find relief:

1. Humidify the Air

Indoor heating and air conditioning can create dry and irritating conditions for the eyes. Humidifying the air in your house or workplace can put moisture back in the air, helping to reduce eye irritation and dryness. This can be accomplished with a store bought humidifier, or you can make a homemade version by filling the bathtub with very warm water to temporarily replace the lost moisture in the air.

2. Avoid Long-Term Use of Eye Drops

Avoid long-term use of eye drops, especially any that contains ingredients such as tetrahydrozoline and naphazoline, and anti-inflammatory drops because long-term use may actually make your red eyes worse. After just a couple of days you may get a rebound effect, causing you to have red eyes for longer periods of time. If allergies are to blame, try using mast cell stabilizer drops for long-term use.

3. Remove All Makeup

Don't sleep with makeup on. Although this is really basic, it does make a difference in the appearance of your eyes the next day. If you want to avoid red eyes in the morning, remove all your makeup before going to bed. This includes any traces of mascara, including your lashes, when washing your face in the evening, because you don’t want to risk the chance of the mascara sliding into your eyes while you're sleeping.

4. Avoid Harsh Cleansers

Avoid using harsh skin care products containing chemicals that can irritate your eyes. Common eye irritants caused by chemical ingredients include benzoyl peroxide and sodium lauryl sulfates. Avoid foaming facial cleansers containing diethanolamine, monoethanolamine, or Triethanolamine, as these are known to be eye irritants.

5. Avoid Cigarette Smoke

If you’re a smoker, consider quitting. Cigarette smoke is a well-known eye irritant. People who smoke, and those that smoke around you, need to keep smoking outside of the home. Unfortunately, those who partake or use medical marijuana will immediately get bloodshot eyes, no matter where they smoke it.

6. Wear Eye Protection

If you don’t protect your skin while outdoors in the sun, you’ll get sunburn, but what about protecting your eyes? The eyes can also suffer damage from prolonged exposure to the sun, resulting in chronic red eyes, or worse long term damage, such as cataracts and macular degeneration. The best eye protection you can use are sunglasses that are marked with a rating of UV400 or more.

When to See a Doctor

Usually having red eyes in the morning is no cause for worry. If you think the redness is caused by a reaction to OTC eye drops, try changing brands or take a break from using them. You may want to contact your healthcare provider for an appointment if the red eyes don’t clear up after a few days, especially if you have a thick or continuous mucous discharge. However, seek emergency medical care for red eye if:

• Your vision suddenly changes.
• You experience severe eye pain or sensitivity to light, accompanied with a fever and extreme headache.
• You are also nauseous or vomiting.
• It is caused by a foreign object or chemical splash.
• You are seeing halos around lights.
• Your red eyes are accompanied by swelling.
• You can’t open your eye, or keep it open.
• You have a constant feeling that something is in your eye.
• If you've had recent eye surgery or an eye injection, and you have red eyes accompanied with pain, contact your eye surgeon for instructions.