In very young patients, nocturnal lagophthalmos tends to be less severe than in older patients and is usually outgrown.
Lagophthalmos can also occur during the day. Patients with this condition do not have a full blink, so there is always a part of the eye that does not receive enough tear lubrication.
Eyelids and Nocturnal LagophthalmosYour eyelids provide a barrier, allowing tears to lubricate the surface of your eyes. Along with nutrients, tears have natural antibiotics to help kill viruses and bacteria. When the barrier is broken, your eye becomes exposed to the outside environment and the tear film begins to evaporate almost immediately. When this occurs night after night, your eyes can become inflamed and the cornea and conjunctiva may form dry spots, ulcers and even scarring if not treated.
Causes of Nocturnal LagophthalmosIt may sound strange, but nocturnal lagophthalmos is actually considered a form of facial paralysis; it involves the orbicularis muscle in the eyelid and may be temporary or permanent. It can be caused by several things including Bell's Palsy, infection, stroke, surgery, and trauma.
What Nocturnal Lagophthalmos Feels LikeIf you suffer from nocturnal lagophthalmos, you may awaken with dry eye symptoms such as a foreign body sensation, redness, pain and blurry vision. Some people also complain of increased light sensitivity.
Treatment of Nocturnal LagophthalmosTreatment usually involves artificial tear eye drops given several times per day along with instillation of a bland eye gel or ointment at bedtime.
To prevent the eyelid from opening at night, medical grade hypoallergenic tape may be gently applied to the eyelid to keep it closed. A mask worn over the eyes may also help. Your doctor may also recommend that you turn down or turn off ceiling fans.
In severe cases, a gold weight may be applied to the outside of the eyelid or surgically implanted inside the eyelid. The gold weight is compatible with the body and uses nature’s gravity to help provide a full blink.
Catania, Louis J. Primary Care of the Anterior Segment, Second Edition. Appleton & Lange, 1995.