Lagophthalmos

You must have seen someone who is sleeping and the eyes looks like it’s not completely closed or when some people try to close their eyes, it’s as if the eyes are till quite opened, also when they blink, the eyelids doesn’t close completely. This condition is called Lagophthalmos.

Lagophthalmos can be explained as the inability to completely close the eyelids, this leads to an opening between the upper and lower eyelids which inturn exposes the eye surface especially the lower portion of the eye surface. This may result into dryness of the eye, causing you to experience symptoms such as foreign body sensation,tearing,blurred vision, eye irritation.and in some cases alters the integrity of the cornea.

Types and causes of Lagophthalmos

Paralytic lagophthalmos;

This is the most common form and is caused by facial nerve paralysis. About 80% of all facial nerve paralysis are caused by Bell’s palsy. Bell’s palsy is a short-term unilateral (one sided) facial nerve paralysis disorder with unknown causes.

Facial nerve paralysis could also be associated with trauma such as temporal bone fracture during some surgical procedures Other causes of facial nerve paralysis include infections such as HIV, Lyme disease, measles, polio and herpes zoster virus (Ramsay-Hunt syndrome). Finally, certain tumors may also cause facial nerve paralysis by compressing the nerves.

Cicatricial lagophthalmos;

This is the result of scarring following a trauma or surgery. The formation of excessive scarring leads to disfiguration of the eyelid, and prevents normal closure. Such cases may include chemical burns, lacerations, or chronic conditions like xeroderma pigmentosum, which is a rare skin disorder that renders the individual ultra-sensitive to sunlight/UV which makes the eye lid susceptible to damage and in turn results into lagophthalmos

Nocturnal lagophthalmos ;

This is a condition in which the eyes remain fully or partially open during sleep. Unlike a constant inability to close the eyelids both during the day and night, this condition only occurs during sleep. As a consequence, patients often suffer from insomnia and feel significant discomfort related to their eyes upon waking.

Can Lagopthalmos be prevented?

Generally, lagophthalmos cannot be prevented as some may just occur on thier own without cause.

 

Treatment Options

When lagophthalmos is mild and causes very few or no symptoms of dryness, treatment basically consists of lubricating the ocular surface to prevent future complications.

In more serious cases, in addition to using lubricant as a treatment therapy, we can also recommend patients for surgical correction, the type of which depends on the degree of exposure and the residual function of the orbicularis muscle in the upper or lower eyelid.

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