Lagophthalmos

The incomplete closure of the eyelids, resulting in inadequate protection of the ocular surface and predisposing to exposure keratopathy, corneal desiccation, epithelial breakdown, and inflammation.

Causes

• Neurological causes

  • Bell's palsy (facial nerve palsy)

  • Stroke affecting facial nerve pathways

  • Acoustic neuroma

  • Herpes zoster (shingles) involving the facial nerve

  • Lyme disease

  • Guillain–Barré syndrome

  • Myasthenia gravis

• Mechanical and structural causes

  • Scarring after burns

  • Facial trauma

  • Stevens–Johnson syndrome with eyelid scarring

  • Exophthalmos/proptosis

    • Thyroid eye disease

    • Orbital tumors

    • Orbital inflammation

  • Ectropion causing eyelid malposition and incomplete closure

  • Congenital eyelid abnormalities

• Surgical and iatrogenic causes

  • Over-aggressive blepharoplasty

  • Eyelid surgery complications

  • Excessive removal of eyelid skin or soft tissue

• Traumatic causes

  • Injury to the orbicularis oculi muscle responsible for eyelid closure

  • Facial soft tissue trauma

  • Orbital injuries

• Sleep-related incomplete eyelid closure (nocturnal lagophthalmos)