Trouble Opening Right Eye After Sleep: Possible Causes and Solutions

Waking up with the right eye unable to open?

Hello Dr.
Wang,
Recently, I have been waking up and finding that I cannot easily open my right eye naturally (it is not stuck due to discharge); I have to exert some willpower to open it.
Additionally, I have some other symptoms that may be related to my eyes, which I will try to list and describe as follows:
1.
Eye muscle soreness (31 years old, right eye muscle soreness; the ophthalmologist said it is due to muscle aging).
2.
Neck and shoulder misalignment (head tilted to the right, with a noticeably higher left shoulder and lower right shoulder.
I have been experiencing shoulder and neck pain similar to a stiff neck frequently over the past 2-3 years).
3.
Swelling felt in the right carotid artery (an ENT specialist performed a neck ultrasound and found nothing; it was noted that there is blood flow disturbance in the right carotid artery, detected in August).
4.
Facial asymmetry (discovered during an adjustment at the optical shop; from the tip of the nose to the ear, the right side is significantly larger than the left.
The optician noted that the difference is much greater than that of an average person).
5.
Migraine (I have been treating it as a cold; sometimes it is accompanied by a light-headed feeling).
6.
A sensation of a foreign body below the larynx, with a desire to vomit (this has occurred frequently over the past 2-3 years; a gastroenterologist performed an endoscopy and found no issues.
Recently, due to problems with my new glasses, I noticed that this sensation disappears when I intentionally do not wear them).
7.
Occasional numbness in the right side of my face (I am unsure if this is related to my eyes).
8.
When looking in the mirror, I sometimes notice that my right eye seems to drift outward involuntarily and then I pull it back.
9.
When closing my eyes to sleep, I feel a slight soreness in the upper right area of my right eye, and I have the sensation that my right eyeball is slightly shifting to the right.
Do I have a problem with my eyes? Additionally, in July, I lost my glasses and went to the original optical shop to get new ones.
With the new glasses, I experienced intense stabbing pain and fatigue in my right eye.
The optical shop could not address this issue, so I sought out multiple optical shops for a refraction and new glasses.
Each shop had its own explanation, but none could resolve the stabbing pain and fatigue caused by the new glasses.
Eventually, I even developed muscle pain in my left eye.
Due to the ongoing pain and discomfort, I visited several ophthalmology clinics, and the doctors all indicated that the prescription for the new glasses should be fine; the only difference noted was in the pupillary distance, which was measured at 63, 65, or 66.
However, regardless of whether it was 63, 65, or 66, wearing the glasses was still uncomfortable.
This issue remains unresolved.
What should I do? If the optical fitting continues to be problematic, would laser surgery for myopia be a good option? Are there any considerations I should be aware of?

A-Xing, 30~39 year old female. Ask Date: 2011/10/31

Dr. Wang Zhishun reply Ophthalmology

Hello, your description is very detailed.
Regarding ophthalmology, there may be symptoms similar to computer vision syndrome, dry eye syndrome, and strabismus, so it is recommended to see an ophthalmologist for an examination.
For other symptoms, it is advisable to consult a neurologist.
Your glasses issue may also be related to the aforementioned conditions, so it would be good to have them checked together.
It is not recommended to seek laser treatment before resolving the issues.
Thank you, and best wishes!

Reply Date: 2011/10/31

More Info

It sounds like you are experiencing a complex set of symptoms that could be related to several underlying issues, particularly concerning your right eye and overall neck and shoulder alignment. Let's break down your symptoms and explore potential causes and solutions.

Symptoms Overview
1. Difficulty Opening Right Eye: This could be due to several factors, including muscle fatigue, nerve issues, or even eyelid dysfunction. If the eye is not physically stuck due to discharge, it may indicate a problem with the muscles that control eyelid movement or a neurological issue.

2. Eye Muscle Pain: The discomfort in the eye muscles could be a result of overuse, strain, or even an underlying condition affecting the muscles or nerves.

3. Neck and Shoulder Issues: The asymmetry in your shoulders and neck pain could contribute to your eye symptoms. Poor posture or muscle tension in the neck can affect the nerves that innervate the eye muscles, leading to discomfort or difficulty in movement.

4. Facial Asymmetry: This could be a sign of underlying muscular or neurological issues. It’s essential to have this evaluated by a specialist.

5. Migraine and Sensations of Numbness: Migraines can cause visual disturbances and may also be linked to neck tension. The numbness in your face could be related to nerve compression or irritation.

6. Feeling of a Foreign Body in the Throat: This sensation could be related to anxiety or muscle tension, which is common in individuals with chronic pain or discomfort.

7. Eye Strain from New Glasses: If your new glasses are not properly fitted or if the prescription is incorrect, this can lead to significant eye strain, discomfort, and fatigue.

Possible Causes
- Muscle Fatigue or Strain: Overuse of the eye muscles, especially if you have been straining to see clearly with new glasses, can lead to pain and difficulty in opening the eye.

- Nerve Issues: Conditions such as Bell's palsy or other neurological disorders could affect the muscles around the eye and face, leading to asymmetry and difficulty in movement.

- Postural Problems: Poor posture can lead to muscle imbalances that may affect the neck and shoulders, which in turn can impact the eyes.

- Visual Disturbances: If your glasses are not correctly prescribed or fitted, it can lead to visual discomfort and strain, exacerbating your symptoms.

Recommendations
1. Consult a Specialist: Given the complexity of your symptoms, it would be wise to consult with a neurologist to rule out any neurological conditions. A thorough examination may include imaging studies or nerve conduction tests.

2. Eye Examination: Return to an ophthalmologist for a comprehensive eye exam, focusing on muscle function and the fit of your glasses. Consider asking for a second opinion if you feel your concerns are not being adequately addressed.

3. Physical Therapy: A physical therapist can help address postural issues and muscle imbalances in your neck and shoulders, which may alleviate some of the strain on your eyes.

4. Re-evaluate Glasses: If your new glasses are causing discomfort, consider returning to the optometrist for a re-evaluation. Ensure that the prescription is accurate and that the frames fit properly.

5. Consider Laser Surgery: If glasses continue to be problematic and you are a suitable candidate, laser eye surgery (like LASIK) could be an option to reduce dependency on glasses. However, this should be discussed thoroughly with an ophthalmologist who can assess your eye health and suitability for the procedure.

6. Lifestyle Adjustments: Ensure you are taking regular breaks from screens, practicing good posture, and managing stress, which can all contribute to muscle tension and discomfort.

Conclusion
Your symptoms are multifaceted and could be interrelated. It’s crucial to approach this systematically, starting with a thorough evaluation by the appropriate specialists. Addressing each aspect of your condition—whether it be muscular, neurological, or visual—will help you find relief and improve your quality of life.

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