Lagophthalmos (lag′of-thal′mŏs) refers to the condition wherein an eyelid fails to properly close. The lid may appear normal when open, but the problem occurs when attempting to close the lid. When the eyelid does not adequately close, the eye surface dries out. Drying of the eye in turn leads to light sensitivity, tearing, and irritation. In more severe cases, scarring and infection of the eye surface develop.
Several conditions lead to lagophthalmos. Weakness or paralysis of the eyelid closing muscle is among the more common This is often associated with weakness or paralysis of all the muscles on the same side of the face (hemifacial paralysis). It is important to identify the cause of facial nerve paralysis. When no underlying cause is identified, hemifacial paralysis is called "Bells Palsy." When eyelid paralysis persists, our preferred treatment is to surgically implant a gold weight into the upper eyelid so gravitational pull on the weight enhances eyelid closure.Other causes of lagophthalmos include scarring or contraction of either eyelid skin or muscle. Surgical correction is often the treatment of choice. Depending on the specific cause of lagophthalmos, several different surgical approaches are available.
Lagophthalmos is often associated with eyelid retraction related to Graves' thyroid related orbitopathy. To learn more about our straightforward "5 STEP PROCESS" to surgically treat Lagophthalmos Click Here.Close Medical Condition
Blepharospasm (blef′ă-rō-spazm′) is the medical term for involuntary eyelid spasms. Most people experience an occasional annoying eyelid twitch. The condition to which blepharospasm refers is far more severe and problematic than such annoying twitches. In blepharospasm, spasms can become so severe that one becomes debilitated from an inability to open the eyes well enough to see.
The most common type of blepharospasm seen in our practice is Benign Essential Blepharospasm (BEB). This unique condition where marked and persistent muscle spasms occur in the eyelids, is surprisingly common. Spasms can extend into the eyebrows, forehead, and lower face. When the lower face becomes involved, it is termed Meige Syndrome.
BEB is thought to be caused by a poorly understood condition deep in the brain. Except for Meige syndrome, BEB is associated with no other known medical problems.
Chemodenervation (injection of Botulinum toxin A-Botox® into the affected muscles) is the treatment option of choice for blepharospasm. Small injections around the eyelids can markedly reduce eyelid spasms for months at a time. In the hands of a specialist, this treatment is safe, and nearly always effective.
To the unknowing, injecting "wrinkle medication" to treat blepharospasm seems odd. In fact, botulinum toxin has been FDA approved and used widely for blepharospasm for at least fifteen years before it became FDA approved for wrinkle treatment.
Hemifacial spasm involves involuntary twitching or spasm of the muscles on one side of the face. This is due to abnormal firing of the facial nerve. Among the causes are abnormal nerve healing after a bout of Bell's Palsy, irritation of the facial nerve by an artery in the brain, facial nerve injury, and tumors. Often there is no know cause.
Before treatment can be undertaken, specific causes such as tumor should be ruled out by physical examination and diagnostic testing. Commonly, no known cause is identified. In these situations we offer chemodenervation. This involves injecting small amounts of botulinum toxin A-Botox® into the offending muscles, which markedly reduces the spasms for several months.