OPHTHALMOLOGY

Q:Lately, I am noticing that my eyelids don’t close all the way. What is this condition called and what is the cause? Should I see my eye doctor?

A:What you are describing sounds like a condition called lagophthalmos in which the eyes do not fully close properly either during the day when blinking, or at night when sleeping. Proper eyelid closure and normal blink reflex are essential to maintain a healthy corneal surface and stable tear film. Each blink of the eye spreads a tear film over the eye and creates a continuous layer of moisture that helps flush out any irritants or foreign bodies and keeps our eye healthy. An inability to blink or close the eyes fully leaves the eye exposed to the elements and poses a risk of increased infection, dryness of the eyes and the corneal surface, and in more severe cases, corneal ulcers or exposure keratitis.

Lagophthalmos is the result of a malfunction of the facial nerves near the eye that can be caused by stroke, trauma, skin and eyelid conditions, complications of various eyelid surgeries, obstructive sleep apnea, Bell’s Palsy, and thyroid disease among others. The condition of lagophthalmos leads to less frequent blinking, incomplete eye closure, and impairment of the nasolacrimal system that produces and drains away tears. Symptoms of this condition may include tearing, watery eyes, weak eyelids, foreign body sensation, dry and/or red eyes particularly in the morning, and blurry vision.

For patients experiencing lagophthalmos, a visit to your eye doctor will be important to help determine the cause and treatment of your particular symptoms. When talking with your eye doctor, be prepared to provide a detailed history of your physical and eye health noting any recent trauma or surgery involving the head, face or eyelids; past infections with attention to occurrences of any herpes zoster infections; past or current symptoms of thyroid disease, stroke, or sleep apnea; recent eye surgeries; and other medical conditions. During the eye examination, your doctor will perform several assessments of your lagophthalmos including eye aperture, ocular motility, eyelid muscles, and a slit-lamp examination of the ocular surface and cornea.

Treatment for lagophthalmos depends on the severity and expected duration of the condition and varies per individual needs. Treatment for mild to moderate cases may include preservative-free artificial tears several times daily to supplement loss of tear film; ophthalmic gel tears or ointments at bedtime and/or during the day; wearing moisture goggles, an eye mask, or taping the eyelids at night when sleeping; or plugs used to block tear ducts to sustain moisture in the eye for longer periods of time. For In more severe cases, surgical intervention may be necessary and include treatments such as gold weights implantation in the eyelids, and specialized eyelid surgery.

If you are diagnosed with and treated for lagophthalmos, make sure to followup with your eye doctor as frequently as recommended to help maintain the health of your eyes. Gregory Eippert, MD 9485 Mentor Ave., #110, Mentor 44060 440-255-1115 www.opivision.com