Treating Lagophthalmos

Treating blink lagophthalmos, caused by lashes that collide, may involve removing lashes, epilating them permanently, or addressing the underlying cause of the misdirected lashes.

With nocturnal lagophthalmos, there are two primary treatment goals. The first, is keeping the eyes closed so that they do not dry out during sleep. The second is sleeping comfortably so as not to disturb sleep. Picking a treatment that works, and making a commitment to it, will help keep the eyes moist and lubricated during sleep.

Finding the treatment, or combination, that works best that you can tolerate, or that you can afford may require experimentation.

Preferred at-home treatment options:

Moisture Chamber Goggles
Lubricating Ointments

Other at-home treatment options:

Some cases of lagophthalmos may require surgery, although less invasive options should first be tried. Surgery is usually reserved for patients with paralytic lagophthalmos.

Surgical options include: weights in the upper eye lids; botulin toxin (Botox) and hyaluronic acid gel injections; various techniques for narrowing of the palpebral fissure (the opening between the eye lids) e.g.: blephorrhaphy and tarsorrhaphy (sewing the eye lids together partially); spring implantation in the lids; surgery to recover nerve function; and lengthening of the upper eyelid muscle.

Reference

Surgical treatment options for paralytic lagophthalmos
Agafonova EI, Grusha IaO.
Vestnik oftalmologii
2010 Sep-Oct;126(5):48-52.
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