I cannot fully close my eyelids and might have lagophthalmos. Will gold eyelid weights help?

Question

I have trouble getting my eyelids fully closed. Doing internet research I have found information about a problem callled lagophthalmos. If this is what I have wrong, is the only or best procedure add gold eyelid weights? Appreciate your help.

Otto Joseph Placik, MD · Answer

There are many options for this and the correction may vary on the surgeon's preference. Believe it or not gold weights are the standard but platinum weights are also available and some claim they are superior. The main problem with weights is that they depend on gravity. They work well when sitting or standing but sometimes they can hold the eye open when laying down. Other surgeons prefer the use of springs which can keep the eyes closed whether sitting or standing. However, springs can fatigue or break over time. Currently there are no perfect options and each has their advantages and disadvantages.

Keshini Parbhu, MD · Answer

There are different solutions for surgically managing lagophthalmos and it depends on why you have it.  For this, you would need an evaluation to determine the best way to correct it.

Chris Thiagarajah, MD · Answer

First and foremost, the cause of the lagophthalmos needs to be determined. This can be caused by benign things but also by causes that need to be researched. If you are having a bell's or facial nerve palsy that may need to be worked up. Also if there is something infiltrating into the lower eyelid..again something that a physician needs to determine the cause. The bottom line is that I wouldnt get a gold weight until the cause of the lagophthalmos is determined.

Hisham Seify, MD, PhD, FACS · Answer

Lagopthalmos is a very wide diagnosis that include many factors. Think about the eye lid closure mechanism as an engine that controls the movement of the lids. If there difficulty in eye closure the problem could be in the engine (the muscle), the wiring (the nerves), the lower lid malposition, or other factors. Gold weights are one of the options in paralytic lagopthalmos (wiring problem). A proper examination by a board certified plastic surgeon with additional training in occuloplastic sugery or an occuloplastic surgeon.All the best!

Janet M. Neigel, MD · Answer

Gold weights are good solution but are usually only used if you have a facial palsy (paralysis). The big question is why can"t you close your eyelids at night? Have you had a trauma, congenital problem, previous surgery or scar tissue ? Sometimes these things need to be evaluated and addressed to figure out the best solution. Often the problem can be treated without surgery with the use of ophthalmic lubricating ointment at bedtime. See your local Oculofacial Plastic Surgeon for a full medical assessment.

I cannot fully close my eyelids and might have lagophthalmos. Will gold eyelid weights help?

Answers (5)

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