Lagophthalmos - Suggestions?

I have undergone a lower eyelid lengthening procedure with a sclera graft in both eyes, but the surgeon who performed this says he cannot help me any further. I believe (but am not certain) that my lagophthalmos began after I had an eye infection in both eyes. The doctor at the time (2007) gave me some drops (not sure what he gave me) to get rid of the infection, and I've had dry eyes ever since. The doctor has since retired and I have been unable to question him about this. Suggestions?

More photos here.

Doctor Answers 2

Lower lid retraction

Without seeing you in person, it certainly looks like you have some lower lid retraction on your right side. it would be hard to imagine that an infection, like a conjunctivitis, caused this.  the lower lid is a dynamic structure, and often relates to the position of the eyeball itself. is the your right eye more prominant than your left? have you ever had any trauma to your eyes? why did you have surgery on your lower lids in the past? there are many questions that your oculoplastic surgeon will want answered. there are also several options for your treatment. if your eye is dry and you wish to avoid surgery you can increase the number of artificial tears you are using or switch to gel tears. alternatively you could try having punctal plugs placed, which make the tears stay around longer. a revision of your lower lid surgery would likely involve raising your lower lids and tightening them.

South Burlington Oculoplastic Surgeon
5.0 out of 5 stars 13 reviews


Your right lower lid is significantly lower than the left and the lid margin is below the inferior limbus (or lower border of the iris).  You should have this re-evaluated to see if there is something else that can be done to correct this.  The status of your graft should be  evaluated and the cause of the lid malposition determined.  Your lid crease is also higher on the left which also contributes to your lagophthalmos.  Another opinion is in order.  You should look for an ophthalmic plastic surgeon or oculoplastic surgeon in your area. 

Gregory Branham, MD
Saint Louis Facial Plastic Surgeon

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