What is Lag-Ophthalmos? | Etiology | complication | treatments

 Lag-Ophthalmos

This condition is characterized by the inability to close the eyelids voluntarily.

Physiologically some people sleep with their eyes open (nocturnal lagophthalmos).


Etiology

  • It occurs in patients with paralysis of orbicularis oculi  muscles facial nerve palsy CN VII,
  • Cicatricial contraction of the lids,
  • Symblepharon - adhesion of eyelid to eyeball
  • severe ectropion  - eyelid turns outward
  • Marked proptosis
  • Eyelid scarring
  • Myxo-edema - hypothyroidism in adults
  • Following over-resection of the levator palpebrae superior muscle for ptosis, and in comatose patients. Due to lack of blinking xerosis of the conjunctiva.
Physiologically some people sleep with their eyes open (nocturnal lagophthalmos) in healthy individuals.

Clinical features

  • It is characterized by incomplete
  •  The Closure of the palpebral aperture is associated with features of the causative disease.

Complications

Normally the cornea is covered by eyelids during sleep and is constantly kept moist by blinking movements during awakening.
  • Complications include 
  • Dry eyes-evaporative
  • Conjunctival xerosis
  • and corneal xerosis and exposure keratitis, Exposure keratopathy
  • Corneal ulcer

Treatment

  1. Measures to prevent exposure keratitis 

  • Artificial tear drops should be instilled frequently and the open palpebral fissures with an antibiotic eye ointment during sleep and in comatosed patients.
  • A soft bandage contact lens may be used to prevent exposure to keratitis.
  • The Tarsorrhaphy may be performed to cover the exposed cornea when indicated.

2. Measures to treat the cause of lagophthalmos Whenever possible should be taken.

  • The artificial tear should be instilled frequently  
  • The Instilled of ointment and closure of lids by a tape or bandage during sleep.
  • A soft bandage contact lens with frequent instillation of artificial tears is required in cases of moderate exposure.
  • Treatment of the causes of exposure: e.g., proptosis, ectropion, symblepharon should be taken up.

Location: United States

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