Lagophthalmos is incomplete closure of the eyelids, leaving part of the ocular surface exposed when blinking or sleeping. It can lead to dryness, irritation, and exposure keratopathy.
Causes
Common causes include facial nerve palsy, over‑tight eyelid or brow surgery, proptosis from thyroid eye disease, and scarring of the lids.
- Patients may wake with sore, gritty eyes or notice watering and light sensitivity.
- Examination shows a persistent gap between the lids on gentle closure.
- The inferior cornea often shows punctate epithelial erosions from exposure.
- Risk of corneal ulcer increases if exposure is severe and untreated.
Management
Treatment aims to protect the cornea using lubrication, taping or moisture chambers at night, and surgical procedures if needed.
- Options include temporary tarsorrhaphy, gold‑weight implantation, and lid tightening surgeries.
- Addressing underlying causes, such as facial palsy or thyroid eye disease, is crucial.
- Regular monitoring ensures the cornea remains healthy while function recovers or reconstruction is planned.
- Patient education on lubrication and lid closure exercises supports outcomes.
