Treatment of Lagophthalmos

• Medical

  Goal: Maintaining a normal corneal epithelium
  • Temporary: Lubrication, moisture chamber
    Used at varying intervals
    Ointments are more effective in corneal protection; however, they often substantially blur vision.
    If this is not effective or if the paralysis is expected to persist, more permanent therapy would include procedures which narrow the palpebral fissure such as tarrsorhaphy (see below)

    • Blinkeze™ External Lid Weights provide an immediate, voluntary blink mechanism for treating ocular exposure associated with temporary facial paralysis such as Bell's palsy.

      BENEFITS

      Effective non-surgical eyelid closure treatment
      Superior patient comfort and ease of use
      • Simplifies supportive eye care
      • Enhanced patient satisfaction
      
      

      Blinkeze Treatment Kit

      

• Surgical (usually wait several months)
  • Goal: Closure of the eyelids to narrow the palpebral fissure and decrease evaporation.
    • Horizontal Closure
      • Permanent: lateral tarsorraphy Tarsorrhaphy has been the standard method of managing exposure keratitis and is often effective if large enough.
        large tarsorrhaphies could be disfiguring and limit peripheral vision.
        a lateral tarsorrhaphy of
      Medial tarsorrhaphies
      • more disfiguring
      • generally used as a last resort in managing surface exposure.
    • Vertical Closure
    • Lower-lid elevation with spacers
    • fascia lata or silicone sling to lower eyelid
    • Hard palate or Alloderm implant
    • Midface lift
    • Upper eyelid lowering
      
      
      gold weight (e.g. Lid Load) insertion a light (1 mg weight ) manufactured by various companies in weights from 0.6 to 1.6 grams could be fixed to pretarsal space of the upper eyelid.
      The weight allows the eyelid to close more easily.
      The weights could be taped to the pretarsal portion of the upper lid to determine which size will be needed to reduce the Lagophthalmos.
      Excess weight could cause Ptosis.
    • Implantation involves an incision at the upper lid crease which exposes the anterior surface of the tarsal plate. The weight is then secured in position

Lagophthalmos: Patients with lagophthalmos have an inability to close eyelids. This could occur, for instance, in patients with Thyroid eye disease. Visit the lagophthalmos page for more details.

Ptosis: Ptosis is sometimes referred to as Blepharoptosis. It refers to an eyelid which is droopy. This could cause a loss of vision, especially while reading, headaches, and eyebrow strain. Please click on the Ptosis page for more details.