Lagopthalmos at Night, Inadequate Blinking 7 Months After Bleph

3rd revision of blepharoplasty with partial myectomy for blepharospasm. I have been taping my eyes shut since the first procedure in oct 09, to the point that the skin around the eye just remains sore all the time, I look 80 yrs old from the face (I am only 52)with no tone esp below one eye, b/l entropion for which I need more botox which makes blinking worse, can't focus very long, double vision with unstable tear film as the upper eye lids don't actually wipe the cornea, they are loose, ...kil

Doctor Answers 3

Lagophthalmos after eyelid surgery

Eyelid gaping is one of the most important side effects of eyelid surgery. First, is to make sure the cornea stays healthy with lubrication, tape (as you've been doing), and regular ophthalmic evaluations. Your lagophthamos sounds complicated since you've had more than one surgery, including myectomy for blepharospasm. Depending on the cause/vector, the treatment varies. If it's skin shortage/contracture, skin grafting may help, if it's related to nerve palsy or nerve damage, tarsorraphy or canthoplasty (anchoring/tightening the eyelid) may help. 

Irvine Oculoplastic Surgeon

Lagophthalmos after myectomy for blepharoaspasm

This can be a difficult problem to treat. The muscle that was partially or totally removed helps to close the eyelid. Also some skin was removed. You need to have aggressive lubrication at night and may eventually need skin grafts to restore skin in the upper eyelid if your cornea is getting regularly damaged. You probably need to have an ophthalmologist in the mix watching your cornea along with your surgeon. Sometimes a partial tarsorhapphy can help with closure. At night eyelid closure problems can be tough to treat. A gold weight is less helpful in this situation. Some surgeons use eyelid springs but they are definitely less common. The most important thing is to protect the eye at this point. 

Chris Thiagarajah, MD
Denver Oculoplastic Surgeon
4.9 out of 5 stars 9 reviews

Lagophthalmos after blepharoplasty

Complications may occur after any procedure, and surgery of the eyelids may result in lagophthalmos, ectropion or entropion, dry eye, and various other conditions. Proper diagnosis of any of these and adequate treatment require evaluation by an ophthalmologist or oculoplastic surgeon. Each surgery causes additional scarring and may reduce the likelihood of an entirely satisfactory result.

Olivia Hutchinson, MD
New York Plastic Surgeon
5.0 out of 5 stars 8 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.