Difficulty closing the eyes fully is called lagophthalmos. It can leave the cornea exposed and vulnerable.
Causes
Facial nerve palsy, thyroid eye disease with proptosis, scarring of the eyelids, and overcorrection from cosmetic or ptosis surgery commonly limit closure. Mechanical factors such as large globe size or eyelid tumours can also interfere.
- Symptoms include dryness, irritation, and waking with sore or red eyes
- Night-time lagophthalmos may go unnoticed until surface damage appears
- Neurological causes often present with facial weakness or asymmetry
- Trauma and burns can distort the eyelids mechanically
Management
Treatment aims to protect the cornea and address the underlying cause. Options range from lubricants, taping, or moisture chambers to gold weight implants or eyelid surgery.
- Urgent care is needed if exposure threatens corneal integrity
- Regular monitoring ensures early detection of surface breakdown
- Facial nerve recovery may gradually improve closure in some cases
- Patients should be counselled about eye protection, especially during sleep
