International Journal of Gerontology
Volume 3, Issue 2 , Pages 89-95, June 2009

Nocturnal Lagophthalmos

  • Shawn H. Tsai

      Affiliations

    • Department of Ophthalmology, Mackay Memorial Hospital, Taipei, Taiwan
    • ,
  • Shu-I Yeh

      Affiliations

    • Department of Ophthalmology, Mackay Memorial Hospital, Taipei, Taiwan
    • ,
  • Lee-Jen Chen

      Affiliations

    • Department of Ophthalmology, Mackay Memorial Hospital, Taipei, Taiwan
    • ,
  • Chien-Hsiu Wu

      Affiliations

    • Department of Ophthalmology, Mackay Memorial Hospital, Taipei, Taiwan
    • ,
  • Shu-Lang Liao

      Affiliations

    • Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Shu-Lang Liao, Department of Ophthalmology, National Taiwan University Hospital, 7, Chung-Shan South Road, Taipei 10002, Taiwan

Accepted 4 March 2009.

Article Outline

Summary 

Nocturnal lagophthalmos is the inability to close the eyelids during sleep. It may be physiological but can cause significant symptoms in some patients. The spectrum of the disease ranges from minimal corneal epithelial changes, which may heal later in the daytime, to corneal ulcers after severe exposure. There are a variety of predisposing factors for lagophthalmos, which can be grouped as proptosis/eye exposure etiologies, palpebral insufficiency etiologies, and idiopathic etiology. The diagnosis is easily missed in subjects having nocturnal lagophthalmos with normal voluntary lid closure (idiopathic). A diagnosis of such cases can usually be made from a detailed history and careful slit lamp examination. A focused clinical evaluation for lagophthalmos in patients complaining of redness, dryness or eye irritation, especially after sleep, will identify most cases. The optimal treatment usually depends on the cause of lagophthalmos. It may include topical agents, lid taping at night or ocular surgery to correct lid malpositioning. This article reviews the incidence, clinical presentations, etiology, diagnosis, examination, and treatments of nocturnal lagophthalmos.

Key Words:  elderly , eye diseases , eyelids , lagophthalmos , sleep

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Mueller FO . Lagophthalmos during sleep . Br J Ophthalmol . 1967;51:246–248
  2. Howitt DA , Goldstein JH . Physiologic lagophthalmos . Am J Ophthalmol . 1969;68:355
  3. Fuchs A , Wu FC . Sleep with half-open eyes, physiologic lagophthalmos . Am J Ophthalmol . 1948;31:717–720
  4. Sturrock GD . Nocturnal lagophthalmos and recurrent erosion . Br J Ophthalmol . 1976;60:97–103
  5. Katz J , Kaufman HE . Corneal exposure during sleep (nocturnal lagophthalmos) . Arch Ophthalmol . 1977;95:449–453
  6. Lyons CJ , McNab AA . Symptomatic nocturnal lagophthalmos . Aust N Z J Ophthalmol . 1990;18:393–396
  7. Latkany RL , Lock B , Speaker M . Nocturnal lagophthalmos: an overview and classification . Ocul Surf . 2006;4:44–53
  8. McNab AA . The eye and sleep . Clin Experiment Ophthalmol . 2005;33:117–125
  9. Bell C . On the motions of the eye in illustration of the uses of the muscles and nerves of the orbit . Philos Trans R Soc Lond . 1823;113:166–186
  10. Hall AJ . Some observations on the acts of closing and opening the eyes . Br J Ophthalmol . 1936;20:257–295
  11. Francis IC , Loughhead JA . Bell's phenomenon: a study of 508 patients . Aust J Ophthalmol . 1984;12:15–21
  12. Ferrer JA . Conclusions from Bell's phenomenon variants . Trans Am Acad Ophthalmol Otolaryngol . 1973;77:OP714–OP720
  13. Holroyd J , Maguen E . And so to sleep: hypnotherapy for lagophthalmos . Am J Clin Hypn . 1989;31:264–268
  14. Miljanovic B , Trivedi KA , Dana MR , Gilbard JP , Buring JE , Schaumberg DA . Relation between dietary n-3 and n-6 fatty acids and clinically diagnosed dry eye syndrome in women . Am J Clin Nutr . 2005;82:887–893
  15. Zoukhri D , Hodges RR , Byon D , Kublin CL . Role of proinflammatory cytokines in the impaired lacrimation associated with autoimmune xerophthalmia . Invest Ophthalmol Vis Sci . 2002;43:1429–1436
  16. Seiff SR , Boerner M , Carter SR . Treatment of facial palsies with external eyelid weights . Am J Ophthalmol . 1995;120:652–657
  17. Shepler TR , Seiff SR . Use of isobutyl cyanoacrylate tissue adhesive to stabilize external eyelid weights in temporary treatment of facial palsies . Ophthal Plast Reconstr Surg . 2001;17:169–173
  18. Gusek-Schneider GC , Erbguth F . [Protective ptosis by botulinum A toxin injection in corneal affectations] . Klin Monatsbl Augenheilkd . 1998;213:15–22 [In German]

PII: S1873-9598(09)70027-4

doi:10.1016/S1873-9598(09)70027-4

International Journal of Gerontology
Volume 3, Issue 2 , Pages 89-95, June 2009

Article Tools