Treatment Details
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Medical
The goal of treating Lagophthalmos medically is to maintain a normal corneal epithelium. This is achieved through the following process:
- 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
The benefit of this approach is effective non-surgical eyelid closure treatment. It provides superior patient comfort and ease of use, simplifies supportive eye care, and enhances patient satisfaction.
Surgical (usually wait several months)
The goal of treating Lagophthalmos surgically is closure of the eyelids to narrow the palpebral fissure and decrease evaporation. With respect to horizontal closure:
- Permanent: lateral tarsorrhaphy has been the standard method of managing exposure keratitis and is often effective if large enough.
- Large tarsorrhaphies might possibly be disfiguring and limit peripheral vision.
- Medial tarsorrhaphies can be more disfiguring and is generally used as a last resort in managing surface exposure.
With respect to 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 might possibly be fixed to pretarsal space of the upper eyelid. The weight allows the eyelid to close more easily, and may be taped to the pretarsal portion of the upper lid to determine which size will be needed to reduce the Lagophthalmos. Excess weight might 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 might possibly 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 might possibly cause a loss of vision, especially while reading, headaches, and eyebrow strain. Please click on the Ptosis page for more details.
