Lagophthalmos

If you suffer from lagophthalmos, you will probably notice that your eyes often stay slightly open even when you try to close them. The fact that part of the eye’s surface remains permanently exposed causes problems of dry eye and eye discomfort, such as irritation and soreness, a stabbing feeling and even pain, among others. Without the right treatment, this discomfort could lead to complications to the eye that damage the cornea.

This disorder is often due to some kind of alteration to the eyelid muscle which means that the eyelids are not in position and do not move properly.  The origins of lagophthalmos might therefore be:

• Paralytic: facial palsy, tumours, injuries, neurological or vascular diseases, etc. can lead to the facial nerve not transmitting impulses correctly to the muscles responsible for closing the eyelids (orbicularis oculi muscles). When this occurs, the muscles progressively lose strength until the eyelids can no longer close in the right position.
• Mechanical: nerve function is normal, but an external element means that the eyelids are unable to close, such as the existence of scars, eyelid laxity, exophthalmos or ectropion.

Much more frequent is nocturnal lagophthalmos: some people do not close their eyes properly when they sleep, and might find it difficult to open their eyes in the morning. If they open them suddenly, they might even notice intense pain and subsequent discomfort throughout the day. Nocturnal lagophthalmos is also very common among children, although it does not often cause any problem.

The treatment of lagophthalmos might include medical and preventive measures aimed at ensuring the eye’s surface remains lubricated to avoid discomfort and irritation due to dry eye: the use of artificial tears and lubricating gels, sleeping with the eye covered to avoid dryness during the night, the use of humidifiers in dry atmospheres, etc.

In other cases we must chose oculoplastic surgery, the technique of which will depend on the source of the problem. For example, surgery to elongate the eyelid tissue, release scars, raise the lower eyelid or lower the upper eyelid might be chosen. Where the eyelid must be reconstructed, we might also decide on a skin, mucus membrane or cartilage graft. The lagophthalmos operation be carried out by a surgeon who specialises in oculoplastics, such as those in the Miranza medical team.