Exposure Keratopathy: An Idiopathic Lagophthalmos Case Report

Exposure keratopathy refers to corneal damage that results primarily from prolonged exposure of the ocular surface to the outside environment. Herein, we describe a case of exposure keratopathy with bilateral idiopathic lagophthalmos and discuss factors pertaining to prompt diagnosis and treatment. A 21-year-old woman presented with bilateral nocturnal lagophthalmos, blurred vision, and whitish spots in both eyes. She had no remarkable history of medication use, trauma, surgery, cranial nerve abnormality, critical illness, or other ocular problems. Examination revealed bilateral lagophthalmos, good Bell's phenomenon, bilateral inferior corneal scars, and vision loss. Laboratory results were normal; there was an absence of proptosis, and no epithelial defects were apparent. Based on these findings, she was diagnosed with exposure keratopathy resulting from idiopathic bilateral lagophthalmos and treated with lubricants.  This was a rare case of exposure keratopathy with bilateral lagophthalmos of idiopathic origin, and a challenging one, which prompted the researchers to formulate an appropriate treatment plan.