Lagophthalmos is incomplete closure of the eyelids, leaving part of the cornea exposed. It may occur from facial nerve palsy, scarring, or proptosis.
Symptoms and causes
Exposure leads to surface dryness and discomfort.
- Grittiness, redness, and blurred vision, often worse on waking
- Observation of a gap between lids during gentle closure or sleep
- Causes include Bell’s palsy, eyelid retraction, post-surgical changes, or thyroid eye disease
- Risk of exposure keratopathy, ulceration, and scarring
Management
Treatment depends on severity and reversibility.
- Frequent lubricants, night-time ointment, and lid taping or moisture goggles
- Gold-weight implantation, tarsorrhaphy, or lid repositioning surgery in persistent cases
- Management of underlying conditions such as facial nerve palsy or thyroid eye disease
- Regular monitoring of the corneal surface
