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Gold in the balance: How does patient posture affect eyelid closure?
1a Moorfields Eye Hospital, NHS Foundation Trust , London , United Kingdom.
Orbit (Amsterdam, Netherlands)
|July 6, 2017
Summary
Upper eyelid gold weights for facial nerve palsy can leave eyes vulnerable when lying flat. Sleeping slightly upright may improve eye closure and protect the ocular surface.
Area of Science:
- Ophthalmology
- Facial Nerve Surgery
Background:
- Facial nerve palsy can cause lagophthalmos, leading to ocular surface exposure.
- Upper eyelid gold weight implantation is a surgical option to improve eyelid closure.
Observation:
- A retrospective audit examined four patients with gold weights implanted over five years ago.
- Eyelid position was assessed at 0°, 45°, and 90° inclinations.
Findings:
- At 0° (lying flat), all patients exhibited significant lagophthalmos with the upper eyelid remaining open, exposing the ocular surface.
- At 45° and 90° (reclined and upright), eyelids closed substantially, protecting the ocular surface.
Implications:
- Gravity influences the effectiveness of upper eyelid gold weights in achieving complete closure.
- Patients with inadequate closure may benefit from sleeping in a slightly upright position to enhance ocular surface protection.
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