“Why does my vision feel hazy in the morning?”

A complete ophthalmologic exam should be performed to determine the cause of your symptoms.

This could be due to dryness. Everyone’s eyes dry out at night. If you have a little dry eye to start with, you could be waking with your cornea being dry which makes you blurry, then when you get up and start blinking, it clears up. You could try artificial tear gel, i.e., genteel gel, before bed and use a tear drop when you awake. This should clear it. You should see an eyecare professional for diagnosis and treatment.

With symptoms like that, you might have a disease of the cornea (Fuchs Dystrophy), which causes the cornea to become swollen overnight when your eyelids are closed and the tears don’t evaporate. A test of the cornea is often done that demonstrates the loss of corneal cells that is present with this disease. Typically, hypertonic saline solution, basically salty tears, are placed into the eye at night and in the morning to reduce the swelling.

It is generally successful and should be sufficient IF THAT IS THE DIAGNOSIS. We also worry about Glaucoma, which blurs the vision if the pressure goes up at night.
Since there are different diseases that can be involved, it is essential to be seen by an ophthalmologist who may be able to make the diagnosis just during his examination.

Roger Ohanesian, MD

Great question. As always the answer to this question depends on your age, duration of symptoms, and of course your eye exam to determine the etiology of your complaint. As a cornea specialist, this is a common complaint in my practice. There is a condition called Fuchs’ Dystrophy, which is a condition that leads to endothelial cell loss (from the cornea) at an early age. The cornea needs to remain clear in order for you to have clear vision, as the cornea accounts for 2/3 of the refractive power of the eye. The endothelial cells serve to pump the fluid out of your cornea all day/night long keeping it clear and functioning well. As you get older and lose these cells, eventually you cross a threshold where the cornea thickens at night while the eyelids are closed (and you don’t have that added benefit of evaporation of fluid off of the corneal surface). Well, this is why patients wake up in the morning with blurry vision that gets better as the morning progresses. There are over-the-counter drops you can use (Muro 128) in the morning and ointment before bedtime. Eventually, when the vision is cloudy for several hours after starting your day, we can do partial cornea transplants (DMEK/DSEK) to restore your sight.

With your complaints, I would definitely recommend getting checked out by an ophthalmologist.

Lee Katzman, MD

While this is not an emergency, you should see your eye doctor immediately. It may be something as simple as dry eye, or more serious, like Fuch's dystrophy of the cornea. Eye drops may be prescribed in either case, depending on the severity.

It sounds like you could have an early form of Fuchs’ Cornea dystrophy. An ophthalmologist or cornea specialist should be consulted. An over the counter eyedrop Muro 128 5% is often helpful with one drop twice a day has been useful in your condition.

The most likely explanation is dryness. If you are in a winter climate, the heat has been on steadily for the past month and the air in the home has become progressively drier. You eyes do not blink while you sleep to re-wet the surface of your eyes and they may therefore be getting dry while you sleep. Purchase some artificial tears from the drug store and apply the drops upon awakening in the morning this will likely clear your vision much faster than just waiting. If this works you want to get a humidifier for your bedroom to humidify the air and help reduce the overnight dryness. You probably have DTS (dysfunctional tear syndrome) and may want to see an Ophthalmologist for further evaluation and treatment.

You will definitely need an eye exam, you might have either dry eye syndrome or some sort of corneal disease causing mild corneal edema which clears up during the day and builds up when the eye is closed at night.

The most common problems to give those symptoms are ocular allergies or blepharitis. They may be long-term. An eye check-up would either elicit the diagnosis or give reassurance.

Try seeing an eye doctor. One reason could be corneal swelling due to dystrophy.