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Lagophthalmos: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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[What causes lagophthalmus?
Causes of lagophthalmia - facial nerve lesion, retraction, eyelid scars, exophthalmos, simblepharon. The defeat of the facial nerve can be congenital, idiopathic (Bell's paralysis), develop as a result of hypothermia, ear disease, meningitis, HIV infection and other diseases. Laphophthalmus is sometimes caused by congenital shortness of the eyelids, but much more often it depends on cicatricial processes on the skin of the face and eyelids and is often caused by a significant protrusion of the eyeball (exophagmus); this is observed with growth behind the eye of the tumor and with other orbital processes.
How is lagophthalmus manifested?
Objectively, the eye slit on the side of the lesion is much wider, the lower eyelid is lowered and lagging behind the eyeball. Due to the inversion of the lower eyelid and tear point, lacrimation appears. Because of the uneven eyelids, the eyes are open during sleep. A permanent or temporary lagophthalmus leads to the development of dry eyes, corneal dystrophy, keratitis, corneal ulcers.
What do need to examine?
How to examine?
How is lagophthalmia treated?
Treatment of a lagophthalmus depends on the cause of the lagophthalmia. When paralysis of the facial nerve is treated with a neurologist under the constant supervision of an ophthalmologist. Local treatment at the initial stage is aimed at moistening the cornea (artificial tear, 20% solution of sulfacil sodium, sea buckthorn oil, ointments with antibiotics, especially at night) and reduction of lacrimation (the eyelid is temporarily tightened with a band-aid). Lateral and medial ligation of the eyelids is performed during the treatment, both with a temporary and with a stable lagophthalmus, in order to avoid damage to the cornea. For the purpose of functional rehabilitation, gold implants are inserted into the upper eyelid, and horizontal lowering of the lower eyelid is performed to tighten it to the eyeball.
It is possible to perform surgical restorative operations - lateral and medial suturing of the eyelids is performed during the treatment (both with temporary and with a resistant lagophthalmus) to avoid defeat of the cornea, the creation of a temporary ptosis. For the purpose of functional rehabilitation, gold implants are inserted into the upper eyelid, and horizontal lowering of the lower eyelid is performed to tighten it to the eyeball.
Recommend the use of soft contact lenses as protective dressings. It is necessary to treat paresis of the facial seal, eyelid eversion, and also to eliminate the causes that caused zysophthalmos.
The prognosis is usually favorable, but if the corneal ulcer is present, it significantly worsens.