Lagophthalmos refers to the inability of an individual to completely close the eyelids and can result in drying of the eyes and irritation, and even permanent damage.
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Pathology
Etiology
- most common in facial nerve palsies (e.g. Bell palsy)
- Ramsay Hunt syndrome 4
- trauma/surgery: scarring of the eyelids 1 (cicatricial lagophthalmos)
- sleep (nocturnal lagophthalmos)
- exophthalmos 3
Treatment and prognosis
Initial therapy includes artificial teardrops and topical eye ointments to prevent corneal irritation and scarring (keratitis).
Surgical treatment can be static i.e. the insertion of small weights into the upper eyelids to assist in adequate eye closure, or dynamic, whereby surgical techniques can improve muscle function of the eyelid to improve eyelid movement 4.
History and etymology
Lagophthalmos is from the Ancient inadequate λαγος meaning 'hare' and οφταλμος meaning 'eye'. This stems from a mistaken belief in Classical times that the hare slept with its eyes open! 2