Use of gold weights to correct lagophthalmos in neuromuscular disease

Upper eyelid gold-weight implants are widely used in the correction of lagophthalmos in many neuromuscular conditions, most commonly facial palsy. The paralytic lagophthalmos that occurs in facioscapulohumeral muscular dystrophy (FSHD) is common and can cause severe ocular complications. It is not usually considered for surgical correction. Upper lid loading with 24K gold implants and reconstructive lower lid surgery in a 64-year-old woman with FSHD corrected eyelid deformity and exposure keratitis. Surgical treatment also markedly improved facial appearance. This treatment may merit wider use in FSHD.