Lagophthalmos

Lagophthalmos is the incomplete or defective closure of the eyelids. The inability to blink and effectively close the eyes leads to corneal exposure and excessive evaporation of the tear film. The main cause of lagophthalmos is facial nerve paralysis (paralytic lagophthalmos), but it also occurs after trauma or surgery (cicatricial lagophthalmos) or during sleep (nocturnal lagophthalmos). The main cause for paralytic lagophthalmos is Bell's palsy but it may be secondary to trauma, infections, tumors, and many other conditions. The main purpose when treating lagophthalmos is to prevent exposure keratitis and reestablish eyelid function. It is equally important for the patient to regain a cosmetically acceptable appearance. Clinical treatment includes lubricant drops and ointments. Surgical procedures include dynamic and static techniques. The decision about the most appropriate method for reconstruction depends on the location, extent, degree and duration of paralysis, etiology, patient's age, health, and expectations. The indications and technical steps of the most used static procedures are described in this review.