LAGOPHTHALMOS

This condition is characterised by inability to
voluntarily close the eyelids.
Etiology. It occurs in patients with paralysis of
orbicularis oculi muscle, cicatricial contraction of the
lids, symblepharon, severe ectropion, proptosis,
following over-resection of the levator muscle for
ptosis, and in comatosed patients. Physiologically
some people sleep with their eyes open (nocturnal
lagophthalmos)
Clinical picture. It is characterised by incomplete
closure of the palpebral aperture associated with
features of the causative disease.
Complications include conjunctival and corneal
xerosis and exposure keratitis.
Treatment. To prevent exposure keratitis artificial tear
drops should be instilled frequently and the open
palpebral fissure should be filled with an antibiotic
eye ointment during sleep and in comatosed patients.
Soft bandage contact lens may be used to prevent
exposure keratitis.
Tarsorrhaphy may be performed to cover the
exposed cornea when indicated. Measures should
be taken to treat the cause of lagophthalmos, wherever
possible.