Lagophthalmos

Lagophthalmos

Lagophthalmos is defined as the inability to close the eyelids completely.

Blinking covers the eye with a thin layer of tear fluid, thereby promoting a moist environment necessary for the cells of the exterior part of the eye. The tears also flush out foreign bodies and wash them away. This is crucial to maintain lubrication and proper eye health. If this process is impaired, as in lagophthalmos, the eye can suffer abrasions and infections. Lagopthalmos leads to corneal drying and ulceration.

Pathophysiology

Lagophtalmos can arise from a malfunction of the Facial nerve. Lagopthalmos can also occur in comatose patients having a decrease in orbicularis tone, in patients having palsy of the facial nerve (7th cranial nerve), and in people with severe skin disorders such as ichthyosis.

Today, lagopthalmos is most likely to arise after an inexperienced or unwise cosmetic/plastic surgeon performs an overenthusiastic upper blepharoplasty, which is an operation performed to remove excessive skin overlying the upper eyelid (suprapalpebral hooding) that often occurs with aging. This can appreciably improve the patient's appearance, and make the patient look younger. If, however, excessive skin is removed, the appearance is unnatural and "lagopthalmos" is one of the signs of such excessive skin removal.

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