[go: up one dir, main page]
Scribd
Upload
665 views10 pages

Lagophthalmos

Lagophthalmos refers to the inability to close the eyelids voluntarily. It can be caused by facial nerve paralysis, exophthalmos, cicatricial ectropion, overcorrection of ptosis, symblepharon, or being comatose. This leads to dryness of the eyes from lack of blinking and risks of exposure keratitis, corneal ulcers, and perforation. Treatments include artificial tears, bandage contact lenses, tarsorrhaphy to cover the cornea, and addressing the underlying cause if possible. Tarsorrhaphy involves suturing the eyelid margins together temporarily to protect the cornea during healing or permanently in cases of permanent seventh nerve pals

Uploaded by

MUHAMMED RAMEES S
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
665 views10 pages

Lagophthalmos

Lagophthalmos refers to the inability to close the eyelids voluntarily. It can be caused by facial nerve paralysis, exophthalmos, cicatricial ectropion, overcorrection of ptosis, symblepharon, or being comatose. This leads to dryness of the eyes from lack of blinking and risks of exposure keratitis, corneal ulcers, and perforation. Treatments include artificial tears, bandage contact lenses, tarsorrhaphy to cover the cornea, and addressing the underlying cause if possible. Tarsorrhaphy involves suturing the eyelid margins together temporarily to protect the cornea during healing or permanently in cases of permanent seventh nerve pals

Uploaded by

MUHAMMED RAMEES S
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
You are on page 1/ 10

LAGOPHTHALMOS

S
 Definition

• Lagophthalmos refers to inability to


close the eyelid voluntarily
 CAUSES

*Paralysis of orbicularis oculi(facial nerve palsy)


*Marked proptosis(thyroid eye disease, orbital tumor, orbital
cellulitis)
*Cicatricial ectropion
*Surgical overcorrection of ptosis
*Symblepharon
*Comatose patient
 CLINICAL FEATURES

*Inability to close the lids

*Dryness of conjunctiva and cornea due to lack of


tear film resurfacing owing to absence of blinking

*Clinical signs of causative disease


 COMPLICATIONS

*Dessication of conjunctiva and cornea


*Exposure keratitis
*Corneal ulcer perforation
Treatments
1Measures to prevent exposure keratopathy
* Artificial tear drops should be instilled frequently and the open
palpebral fissure should be filled with an antibiotic eye ointment
following by eyelid taping during sleep and informatised patients.

* Bandage contact lens (BCL) may be used to prevent exposure


keratitis.

*Tarsorrhaphy may be performed to cover the exposed cornea when


indicated.
2. Measures to treat the cause lagophthalmos, wherever possible
should be taken.
Tarsorrhaphy
In this operation, adhesions are created between a part of the lid margins with the aim
to narrow down or almost close the palpebral aperture It is of two types :temporary and
permanent.

Temporary tarsorrhaphy

Indications. (i) To protect the cornea when seventh nerve palsy is expected to
recover(ii) To assist healing of an indolent corneal ulcer. (iii) To assist in healing of
skin-grafts of the lids in the correct position .
Surgical technique. This can be carried out as median or paramedian tarsorrhaphy
i.Incision. For paramedian tarsorrhaphy about 5 mm long incision site is marked on the
corresponding parts of the upper and lower lid margins, 3 mm on either side of the
midline. An incision 2 mm deep is made in the grey line on the marked site and the
marginal epithelium is then excised taking care not to damage the ciliary line anteriorly
and the sharp lid border posteriorly.
ii. Suturing. The raw surfaces thus created on the opposing parts of the lid margins
are then sutured with double-armed 6-0 silk sutures passed through a rubber
bolster.

2. Permanent tarsorrhaphy

Indications. (1) Established cases of VII nerve palsy where there is no chance of
recovery; and (ii) established cases of neuroparalytic keratitis with severe loss of
corneal sensations. Technique. It is performed at the lateral canthus to create
permanent adhesions. The eyelids are overlapped after excising a triangular flap of
skin and orbicularis from the lower lid and corresponding triangular
tarsoconjunctival flap from the upper lid.
THANK YOU

You might also like