Lagophthalmos

Eyelids act as protective covers for your eyes. Proper closure and blinking of your eyelids is essential for normal ocular health and functionality. Lagophthalmos is the inability to fully close the upper eyelid. It is a form of facial paralysis affecting the obicularis muscle in the eyelid and it usually affects only one side of the face. With incomplete lid closure your eye is constantly exposed to the drying effects of outside air as well as to dust particles and debris. This may result in chronic corneal inflammation (keratitis) and scarring.

When you blink a thin film of tears is constantly bathing your eyes. This tear film:

• flushes out and washes away any particles that get past your eyelids and lashes
• provides necessary nutrients and hydration to the cornea
• protects the corneal surface against infections
• helps create a smooth corneal surface so vision stays clear and undistorted

With lagophthalmos there is incomplete closure of the lids and the tear film is not evenly spread over the entire corneal surface. As a result your eyes are not being protected and dry eye symptoms including irritation redness and decreased vision can result.

Some people have a condition called nocturnal lagophthalmos otherwise known as “sleeping with your eyes open.” Generally a person with this condition is unable to close their eyes completely when they sleep. As a result there is greater tear film evaporation and exposure to more dust and debris during the overnight hours.

Both types of lagophthalmos can be a result of another condition or incident such as:

• Bell’s Palsy
• Trauma
• Neurosurgery
• Bacterial Infection
• Stroke

Lagophthalmos can either be a temporary or permanent condition. If your eye care practitioner estimates that your particular case will last less than six months he/she will most likely recommend a regimen of eyedrops and ointments to keep your eye well-lubricated. Treatment solutions for nocturnal lagophthalmos include applying ointments before bedtime and wearing a protective eye mask at night. If your case is permanent or persisting longer than anticipated then your doctor may consider implant surgery.

The most common procedure for this condition involves the placement of a small thin pure gold weight into your eyelid. This is not a gold filling like in your tooth – it is generally invisible and inconspicuous to the outside world. When it is implanted into your lid the weight will allow gravity to pull your eye closed when your muscles relax. Correspondingly when you tense your eyelid muscle your eyelid will open naturally. This procedure is very simple and usually done on an outpatient basis. Since pure gold is biologically stable and inert it will never break down and can be removed at any time. Without question this is one of the most original and interesting treatments in eye care to date.