Patient Information - Lagophthalmos


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What is Lagophthalmos and what are its causes?

Lagophthalmos, from the Greek word for ‘hare’, describes a condition where a patient loses full function of one or both eyelids.  Unlike the hare, which sleeps with his eyes open, human patients with untreated Lagophthalmos need to seek medical evaluation for this condition.  Lagophthalmos frequently results from paralysis of the facial nerve (7th cranial nerve), which controls eyelid function (orbicularis oculi).  This paralysis can be permanent or transitory and can be caused by Bell’s palsy, trauma or stroke.  It can also be an indirect consequence of the surgical removal of certain types of tumors in close proximity to the facial nerve.

 

Can Lagophthalmos be a serious condition?

Lagophthalmos can be a serious condition.  The ability to close the eyelid (and blink) is crucial to the distribution of the surface film necessary to maintain lubrication and proper eye health.  When the eyelid becomes paralyzed, the blink mechanism no longer functions and the eye becomes dry, painful, and irritated.  Prolonged dehydration can lead to serious problems including loss of vision.

 

Is there a temporary treatment for Lagophthalmos?

Your physician may recommend eye drops and ophthalmic ointments to keep your eye well lubricated. A Blinkeze External Lid Weight, positioned on the upper eyelid, may also be prescribed.  MedDev’s Blinkeze External Lid Weights are manufactured from pure tantalum, a dense metal with high biocompatibility. This weight simply uses gravity to gently close the upper eyelid when the patient looks down, or when the eyelid muscle is relaxed.  MedDev offers Blinkeze External Lid Weights in a variety of skin tones to match your complexion.  Your prescribed Blinkeze External Lid Weight Treatment Kit includes a supply of double-sided hypoallergenic adhesive strips for attaching the weight to your eyelid, a mirror and detailed instructions.

As always, if you experience sensitivity or discomfort while wearing your Blinkeze External Lid Weight, or if the prescribed weight is no longer effective, contact your physician.

What if my paralysis does not improve?

If your paralysis does not improve or is not expected to improve after a period of time, your physician may prescribe other treatments, including the surgical placement of a Gold or Platinum Eyelid Implant Weight.

The Eyelid Implant Weight functions similarly to our Blinkeze External Lid Weight to close the upper eyelid, however, implanted gold or platinum weights are less conspicuous and easier to manage.

MedDev offers two eyelid implant designs, the Contour® and the ThinProfile®.  These implant designs can be ordered in similar weights but differ in dimensional thickness and width.  Your physician will determine which implant design is best suited for your use.

Why are eyelid implants made of gold and platinum?

Pure gold and platinum both exhibit highly desirable properties when used as subcutaneous implant materials.  Both metals are dense (heavy), inert, and highly biocompatible (they do not cause irritation to surrounding tissues).  Platinum is approximately 10% more dense than gold, allowing for a smaller implant profile.  The color of our gold implant closely matches that of surrounding fatty tissues, making the implant less conspicuous, even in patients with thin skin.

 

What happens if my doctor decides I need an eyelid implant?

If you have been wearing a Blinkeze External Lid Weight, your physician will already have a good indication of the right implant for you.  If you have not worn a Blinkeze External Lid Weight, your physician will need to evaluate eyelid function using various weights.  Since the levator oculi, the muscle that controls eyelid function, may strengthen over time, proper implant weight will close your eyelid slightly lower when compared to ‘normal’ eyelid function, when looking down.  Once the correct weight is determined, your physician can order the proper gold or platinum eyelid implant for your use.

 

What happens during the implant procedure?

The surgical implant procedure usually takes less than one hour and can be done on an outpatient basis under local anesthesia.  The surgery is frequently combined with other minor procedures to tighten the lower eyelid or major procedures to improve facial palsy.                                                                                                                                 During the procedure, your physician makes an incision on the surface of your upper eyelid above the lashes (see figure 4).                  figure 4

A small pocket is created in which the eyelid implant is inserted (see figure 5).  The eyelid implant will be held in position inside this pocket with small sutures. Additional sutures are used to close the incision and an antibiotic ointment will be applied to the closed incision.  A protective pad can be worn to cover the eye.                                                                                                                                                                                                                                                   

                                                                                                                                                                                       figure 5

What happens after the procedure?

A follow-up appointment will be scheduled, usually a few days after the procedure, to remove the sutures and check on post-operative condition.  You should now experience improved eyelid closure and blink function.  After the swelling subsides, you will notice a small thickness in your eyelid where the eyelid implant is secured.  You may experience minor discomfort, swelling, bruising, and/or a slight redness near the incision line.  In a short time this discomfort will disappear and the incision line will fade (see figure 6a and 6b). 

 Excessive swelling, inflammation, or pain after your procedure is rare.  In the unlikely event that such a problem should occur, notify your physician.  For further information about this procedure, please consult your physician.

How safe are Gold Eyelid Implants?                                                    figure 6a

MedDev Corporation’s eyelid implants have been available worldwide for over 30 years and are an accepted eyelid closure device.  The procedure, combined with rapid surgical recovery, results in improved eyelid function and corresponding improved eye health.  Eyelid weight implantation can provide both aesthetic and functional improvement with minimal risk.                                                                                                                                                                                     

                                                                                                                                                                          figure 6b

 The procedure is easily reversible if normal eyelid function is regained.  Complications, which are very rare, can include sensitivity to gold.  For patients with a gold allergy we offer platinum eyelid implants.  In extremely rare cases, the eyelid implant may become displaced or the implant may erode through surface skin.  Such complications can be readily corrected but may require additional minor surgery.  Consult your physician if any of these conditions appear.

For over 30 years, MedDev has manufactured eyelid implants.  Our products have undergone rigorous testing to assure the highest quality.  The purity of the gold and platinum used in our implants exceeds 99.99% (confirmed by independent analysis).

How can I get more information?

A list of medical articles discussing the treatment of lagophthalmos using eyelid weights is available from MedDev Corporation on this web site or by request.

 

PATIENT INFORMATION

To view a PDF of our Patient Information brochure, simply follow the link below.

For additional information, Contact Us or Call MedDev Customer Service at 800.543.2789 (M-F 8:30 am – 5 pm PST).

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