Tag: Eyelid

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Blepharochalasis

Definition:
Blepharochalasis is an inflammation of the eyelid that is characterized by exacerbations and remissions of eyelid edema, which results in a stretching and subsequent atrophy of the eyelid tissue resulting in redundant folds over the lid margins. It typically affects only the upper eyelids, and may be unilateral as well as bilateral.

click to see the pictures

Subjective: Lax, wrinkled, and baggy eyelid skin

Blepharochalasis results from recurrent bouts of painless eyelid swelling, each lasting for several days. This is thought to be a form of localized angioedema, or rapid accumulation of fluid in the tissues. Recurrent episodes lead to thin and atrophic skin. Damage to the levator palpebrae superioris muscle causes ptosis, or drooping of the eyelid, when the muscle can no longer hold the eyelid up.

These episodes often result in eyelid skin redundancy. In 1817, Beer initially described the condition; however, in 1896, Fuchs first assigned the term blepharochalasis to this entity. The word blepharochalasis originates from the Greek blepharon (eyelid) and chalasis (a relaxing).

Various disease stages have been observed. In 1926, Benedict described a swelling stage and a subsequent stage characterized by thinning skin. Others have suggested an active, intumescent phase that precedes a quiescent, atrophic phase.

It is encountered more commonly in younger rather than older individuals.

Symptoms:
•Droopy eyelid
•Eyelid swelling
•Stretched eyelid
•Degeneration of the eyelid
•Thin eyelids

Causes:
Blepharochalasis is idiopathic in most cases, i.e., the cause is unknown. Systemic conditions linked to blepharochalasis are renal agenesis, vertebral abnormalities, and congenital heart disease.

Complications:
Complications of blepharochalasis may include conjunctival hyperemia (excessive blood flow through the moist tissues of the orbit), chemosis, entropion, ectropion, and ptosis.

Diagnosis:
Blepharochalasis is often confused with dermatochalasis, which refers to the lax and redundant skin most commonly observed in the upper eyelids with aging. However, dermatochalasis is usually not associated with recurrent attacks of edema, “cigarette-paper” skin, and subcutaneous telangiectasia, as observed in blepharochalasis.

Treatment:-
Surgery:…

A surgeon trained to do eyelid surgery, such as a plastic surgeon or ophthalmologist, is required to decide and perform the appropriate surgical procedure. Following procedures have been described for blepharochalasis:

*External levator aponeurosis tuck
*Blepharoplasty
*Lateral canthoplasty
*Dermis fat grafts

These are used to correct atrophic blepharochalasis after the syndrome has run its course.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://en.wikipedia.org/wiki/Blepharochalasis
http://emedicine.medscape.com/article/1214014-overview
http://www.nature.com/eye/journal/v18/n4/fig_tab/6700668f2.html

http://elementsofmorphology.nih.gov/index.cgi?tid=995a2398db7eefe2

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Ectropion and Entropion

Definitions:

Ectropion:If the lower eyelid turns outwards, it starts to hang away from the eyeball and forms a small bucket or pocket.

This may not cause any problems. But as tears collect, the bucket overflows and the lower eyes may water constantly.

CLICK & SEE THE PICTURES
In contrast, the middle part of the eyeball becomes exposed, dry and irritated, which may allow recurrent infections to occur.

When ectropion is due to ageing, usually both eyes are affected. If only one is affected, this may be the result of scarring on the eyelid or upper cheek. As this scar heals and tightens it tugs at the lower eyelid, pulling it down.

Ectropion can also occur when the nerve supplying the lower eyelid muscle has been damaged, causing the muscle to be paralysed.
Ectropion is also found in dogs as a genetic disorder in certain breeds.

Causes:
*Congenital
*Aging
*Scarring
*Mechanical
*Allergic
*Facial nerve palsy
*Anti-cancer treatments such as erlotinib, cetuximab, and panitumumab, which block the function of EGFR (the epidermal growth factor receptor).

Ectropion in dogs:…. CLICK & SEE
Ectropion in dogs usually involves the lower eyelid. Often the condition has no symptoms, but tearing and conjunctivitis may be seen. Breeds associated with ectropion include the Cocker Spaniel, the Saint Bernard, the Bloodhound, and the Basset Hound. It can also result from trauma or nerve damage. Treatment (surgery) is only recommended if there is chronic conjunctivitis or if there is corneal damage. A small part of the affected lid is removed and then the lid is sewn back together.

Entropion :When the upper, lower or both eyelids turn inwards, the eyelashes can rub against the eyeball. This irritates the eye, which can feel painful and watery. Damage to the cornea, the clear front part of the eye, may cause an ulcer to develop that can lead to loss of vision if not treated.
  CLICK & SEE
Entropion usually occurs as a consequence of the ageing process. In developing countries, however, infection affecting the inner surface of the eyelid is a relatively common cause. When this heals, it can leave scar tissue that pulls the outer border of the eyelid inwards.

In a condition called trichiasis, the eyelashes grow inwards, causing identical problems to entropion.

Symptoms:
*Redness and pain around the eye
*Sensitivity to light and wind
*Sagging skin around the eye
*Excessive tearing
*Decreased vision, especially if the cornea is damaged

Causes:
*Congenital
*Aging
*Scarring
*Spasm

Entropion in dogs……..CLICK & SEE
Entropion has been documented in most dog breeds, although there are some breeds (particularly purebreds) that are more commonly affected than others. These include the Akita, Pug, Chow Chow, Shar Pei, St. Bernard, Cocker Spaniel, Boxer, Springer Spaniel, Labrador Retriever, Cavalier King Charles Spaniel, Neapolitan Mastiff, Bull Mastiff, Great Dane, Irish Setter, Shiba Inu , Rottweiler, Poodle and particularly Bloodhound. The condition is usually present by six months of age. Entropion can also occur secondary to pain in the eye, scarring of the eyelid, or nerve damage. The upper or lower eyelid can be involved, and one or both eyes may be affected. When entropion occurs in both eyes, this is known as “bilateral entropion.”

Upper lid entropion involves the eyelashes rubbing on the eye, but the lower lid usually has no eyelashes, so little or no hair rubs on the eye. Surgical correction is used in more severe cases. A strip of skin and orbicularis oculi muscle are removed parallel to the affected portion of the lid and then the skin is sutured. Shar Peis, who often are affected as young as two or three weeks old, respond well to temporary eyelid tacking. The entropion is often corrected after three to four weeks, and the sutures are removed.

Treatment:
Daily eye cleansing with boiled water that’s been allowed to cool, or with an eye wash solution from the pharmacist, can help to keep the eye clean and soothe any symptoms of irritation and soreness. Any infection can be easily treated with antibiotic drops or ointment.

It’s possible to have a minor operation on the eyelid to tighten the skin and muscles. The sooner this is done the better, to avoid further damage to the eye. You may be advised to tape the eye closed to protect it until surgery is performed.

The operation is usually done as a day case under local anaesthetic.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://en.wikipedia.org/wiki/Ectropion
http://en.wikipedia.org/wiki/Entropion
http://www.bbc.co.uk/health/physical_health/conditions/entropion1.shtml
http://www.cosmeticeyelids.com/wea-gallery_ectropion.htm
http://www.eyeplasticsurgery.net/patientinfo/entropion.html

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Blepharospasm

Definition:
Benign essential blepharospasm (BEB) is a progressive neurological disorder characterized by involuntary muscle contractions and spasms of the eyelid muscles. It is a form of dystonia, a movement disorder in which muscle contractions cause sustained eyelid closure, twitching or repetitive movements. BEB begins gradually with increased frequency of eye blinking often associated with eye irritation.

CLICK & SEE
click to see the picture
Benign means the condition is not life threatening. Essential indicates that the cause is unknown, but fatigue, stress, or an irritant are possible contributing factors. Symptoms sometimes last for a few days then disappear without treatment, but in most cases the twitching is chronic and persistent, causing lifelong challenges. The symptoms are often severe enough to result in functional blindness. The person’s eyelids feel like they are clamping shut and will not open without great effort. Patients have normal eyes, but for periods of time are effectively blind due to their inability to open their eyelids.

Although strides have recently been made in early diagnosis, blepharospasm is often initially mis-diagnosed as allergies or “dry eye syndrome“. It is a fairly rare disease, affecting only one in every 20,000 people in the United States.


Symptoms:
*Excessive blinking and spasming of the eyes, usually characterized by uncontrollable eyelid closure of durations longer than the typical blink reflex, sometimes lasting minutes or even hours.
click for the picture
*Uncontrollable contractions or twitches of the eye muscles and surrounding facial area. Some sufferers have twitching symptoms that radiate into the nose, face and sometimes, the neck area.

*Dryness of the eyes

*Sensitivity to the sun and bright light

click to see the picture
Causes:
Some causes of blepharospasm have been identified; however, the causes of many cases of blepharospasm remain unknown, although some educated guesses are being made. Some blepharospasm patients have a history of dry eyes and/or light sensitivity, but others report no previous eye problems before onset of initial symptoms.

Some drugs can induce blepharospasm, such as those used to treat Parkinson’s disease, as well as sensitivity to hormone treatments, including estrogen-replacement therapy for women going through menopause. Blepharospasm can also be a symptom of acute withdrawal from benzodiazepine dependence. In addition to blepharospasm being a benzodiazepine withdrawal symptom, prolonged use of benzodiazepines can induce blepharospasm and is a known risk factor for the development of blepharospasm.

Blepharospasm may also come from abnormal functioning of the brain basal ganglia. Simultaneous dry eye and dystonias such as Meige’s syndrome have been observed. Blepharospasms can be caused by concussions in some rare cases, when a blow to the back of the head damages the basal ganglia.

Blepharospasm often occurs out of the blue for no specific reason. Rarely, it can run in families.

Diagnosis:
The diagnosis of blepharospasm depends on recognition of its characteristic features by an expert, such as a neurologist or ophthalmologist. There are no medical tests for proving the diagnosis, but some tests may be conducted to rule out other possible problems. These may include tests for allergies or dry eyes or scans of the brain.


Treatment:
*Drug therapy: Drug therapy for blepharospasm has proved generally unpredictable and short-termed. Finding an effective regimen for any patient usually requires trial and error over time. In some cases a dietary supplement of magnesium chloride has been found effective.

*Botulinum toxin injections (Botox is a widely known example) have been used to induce localized, partial paralysis. Among most sufferers, botolinum toxin injection is the preferred treatment method.[3] Injections are generally administered every three months, with variations based on patient response and usually give almost immediate relief (though for some it may take more than a week) of symptoms from the muscle spasms. Most patients can resume a relatively normal life with regular Botulinum toxin treatments. A minority of sufferers develop minimal or no result from Botox injections and have to find other treatments. For some, Botulinum toxin diminishes in its effectiveness after many years of use. An observed side effect in a minority of patients is ptosis or eyelid droop. Attempts to inject in locations that minimize ptosis can result in diminished ability to control spasms.

*Surgery: Patients that do not respond well to medication or botulinum toxin injection are candidates for surgical therapy. The most effective surgical treatment has been protractor myectomy, the removal of muscles responsible for eyelid closure.

*Dark glasses are often worn because of sunlight sensitivity, as well as to hide the eyes from others.

*Stress management and support groups can help sufferers deal with the disease and prevent social isolation.

Prognosis:
With botulinum toxin treatment most individuals with BEB have substantial relief of symptoms. Although some may experience side effects such as drooping eyelids, blurred or double vision, and eye dryness, these side effects are usually only temporary.

Researches:
The NINDS supports a broad program of research on disorders of the nervous system, including BEB. Much of this research is aimed at increasing understanding of these disorders and finding ways to prevent, treat, and cure them.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://en.wikipedia.org/wiki/Blepharospasm
http://www.ninds.nih.gov/disorders/blepharospasm/blepharospasm.htm
http://www.bbc.co.uk/health/physical_health/conditions/blepharospasm1.shtml
http://www.nature.com/eye/journal/v18/n3/fig_tab/6700624f1.html
http://microbewiki.kenyon.edu/index.php/File:Botwoman.jpg
http://rarediseasesnetwork.epi.usf.edu/dystonia/patients/learnmore/craniofacial/

http://www.graphicshunt.com/health/images/blepharospasm-608.htm

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Ptosis (eyelid)

Definition:-
Ptosis is an abnormally low position (drooping) of the upper eyelid. The drooping may be worse after being awake longer, when the individual’s muscles are tired. This condition is sometimes called “lazy eye“, but that term normally refers to amblyopia. If severe enough and left untreated, the drooping eyelid can cause other conditions, like amblyopia or astigmatism. This is why it is especially important for this disorder to be treated in children at a young age, before it can interfere with vision development.

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Ptosis refers to the drooping of an eyelid, and it affects only the upper eyelid of one or both eyes. The droop may be barely noticeable, or the lid can descend over the entire pupil. Ptosis can occur in both children and adults, but usually happens because of aging.

Causes:-
Ptosis (pronounced toe’ sis), or drooping of the upper eyelid, may occur for several reasons such as: disease, injury, birth defect, previous eye surgery and age. In most cases, it is caused by either a weakness of the levator muscle (muscle that raises the lid), or a problem with the nerve that sends messages to the muscle.

Children born with ptosis may require surgical correction of the lid if it covers the pupil. In some cases, it may be associated with a crossed or misaligned eye (strabismus). Left untreated, ptosis may prevent vision from developing properly, resulting in amblyopia, or lazy eye.

Patients with ptosis often have difficult blinking, which may lead to irritation, infection and eyestrain. If a sudden and obvious lid droop is developed, an ophthalmologist should be consulted immediately.

Ptosis occurs when the muscles that raise the eyelid (levator and Müller’s muscles) are not strong enough to do so properly. It can affect one eye or both eyes and is more common in the elderly, as muscles in the eyelids may begin to deteriorate. One can, however, be born with ptosis. Congenital ptosis is hereditary in three main forms. Causes of congenital ptosis remain unknown. Ptosis may be caused by damage/trauma to the muscle which raises the eyelid, or damage to the nerve (3rd cranial nerve (oculomotor nerve)) which controls this muscle. Such damage could be a sign or symptom of an underlying disease such as diabetes mellitus, a brain tumor, and diseases which may cause weakness in muscles or nerve damage, such as myasthenia gravis.

Classification:-
Depending upon the cause it can be classified into:

*Neurogenic ptosis which includes oculomotor nerve palsy, Horner’s Syndrome, Marcus Gunn jaw winking syndrome, IIIrd cranial nerve misdirection.

*Myogenic ptosis which includes myasthenia gravis, myotonic dystrophy, ocular myopathy, simple congenital ptosis, blepharophimosis syndrome

*Aponeurotic ptosis which may be involutional or post-operative.

*Mechanical ptosis which occurs due to edema or tumors of the upper lid

*Neurotoxic ptosis which is a classic symptom of envenomation by elapids such as cobras, or kraits. Bilateral ptosis is usually accompanied by diplopia, dysphagia and/or progressive muscular paralysis. Neurotoxic ptosis is a precursor to respiratory failure and eventual suffocation caused by complete paralysis of the thoracic diaphragm. It is therefore a medical emergency and immediate treatment is required.

*pseudo ptosis due to:1-Lack of lid support:Empty socket or atrophic globe. 2-Higher lid position on the other side: As in lid retraction

Signs and Symptoms:-
The causes of ptosis are quite diverse. The symptoms are dependent on the underlying problem and may include:

*Drooping lid (may affect one or both eyes)

*Irritation

*Difficulty closing the eye completely

*Eye fatigue from straining to keep eye(s) open

*Children may tilt head backward in order to lift the lid

*Crossed or misaligned eye

*Double vision

Detection and Diagnosis:-
When examining a patient with a droopy lid, one of the first concerns is to determine the underlying cause. The doctor will measure the height of the eyelid, strength of the eyelid muscles, and evaluate eye movements and alignment. Children may require additional vision testing for amblyopia.

Treatment:-
Ptosis does not usually improve with time, and nearly always requires corrective surgery by an ophthalmologist specializing in plastic and reconstructive surgery. In most cases, surgery is performed to strengthen or tighten the levator muscle and lift the eyelid. If the levator muscle is especially weak, the lid and eyebrow may be lifted. Ptosis can usually be performed with local anesthesia except with young children.

Aponeurotic and congenital ptosis may require surgical correction if severe enough to interfere with vision or if cosmesis is a concern. Treatment depends on the type of ptosis and is usually performed by an ophthamolic plastic and reconstructive surgeon, specializing in diseases and problems of the eyelid.

Surgery is usually the best treatment for drooping eyelids. The surgeon tightens the levator muscles, and you come away with improved vision and appearance. In very severe cases involving weakened levator muscles, the surgeon attaches the eyelid under the eyebrow to allow the forehead muscles to substitute for the levator muscles in lifting the eyelid. Eyelid surgery is also known as blepharoplasty.

After surgery, the eyelids may not appear symmetrical, even though the lids are higher than before surgery. Very rarely, eyelid movement may be lost.

It is important to choose your surgeon carefully, since poorly done surgery could result in an undesirable appearance or in dry eyes from lifted eyelids not closing completely.

Before agreeing to ptosis surgery, ask how many procedures your surgeon has done. Also ask to see before-and-after photos of previous patients, and ask if you can talk to any of them about the experience.

Surgical procedures include:
———————————–
*Levator resection

*Müller muscle resection

*Frontalis sling operation

Non-surgical modalities like the use of “crutch” glasses to support the eyelid may also be used.

Ptosis that is caused by a disease will improve if the disease is treated successfully.

Ptosis Strips:–
Ptosis strips from FCI Ophthalmics have been developed to treat frontalis suspension in patients with significant ptosis and poor levator functioning. FCI Ptose-Up strips are easy to place and adjust, and they provide an excellent eyelid contour. The strips are made of a biocompatible, porous, inert, biointegratable, non-toxic, ready to use, non-allergenic material. FCI ptosis strips can be removed in the case of overcorrection, or if the patient experiences dry eye problems as a result of treatment.

Ptosis in Children:–
Children born with moderate or severe ptosis require treatment in order for proper vision to develop. Failure to treat ptosis can result in amblyopia (diminished vision in one eye) and a lifetime of poor vision.

All children with ptosis, even mild cases, should visit their eyecare practitioner every year. The eyes change shape as they grow, and sometimes focusing and visual problems develop, all because of the worsening ptosis.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.


Resources:
http://en.wikipedia.org/wiki/Ptosis_(eyelid)
http://www.stlukeseye.com/conditions/Ptosis.asp
http://www.allaboutvision.com/conditions/droopinglids.htm
http://www.fci-ophthalmics.com/html/lid.html

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Lagophthalmos

Synonym(s): Hare’s eye

[G. lagos, hare + ophthalmos, eye]

Definition:
Lagophthalmos is defined as the inability to close the eyelids completely. A condition in which a complete closure of the eyelids over the eyeball is difficult or impossible.

Blinking covers the eye with a thin layer of tear fluid, thereby promoting a moist environment necessary for the cells of the exterior part of the eye. The tears also flush out foreign bodies and wash them away. This is crucial to maintain lubrication and proper eye health. If this process is impaired, as in lagophthalmos, the eye can suffer abrasions and infections. Lagopthalmos leads to corneal drying and ulceration.

click to see the pictures...(01)…...(1).……(2)..…...(3).…...(4).…...(5)..….(6I).…..(7).....

Nocturnal lagophthalmos is the inability to close the eyelids during sleep. Lagophthalmos is associated with exposure keratopathy, poor sleep, and persistent exposure-related symptoms.

Detection:There are a variety of causes of lagophthalmos, grouped as proptosis/eye exposure etiologies and palpebral insufficiency etiologies. Although obvious lagophthalmos is usually detected, it is sometimes difficult to recognize obscure lagophthalmos, due either to eyelash obstruction or overhang of the upper lid anterior and inferior to the most superior portion of the lower lid in a closed position. A novel classification system and illustrations of obvious and obscure lagophthalmos for detection.

Causes:
The inability to provide function to the eyelid is typically secondary to a previous or ongoing condition, surgery, or event. This paralysis is usually isolated to just one side of the face. Lagophthalmos and facial paralysis are typically diagnosed due to:

*Bell’s Palsy
*Trauma
*Neurosurgery
*Bacterial infection
*Cerebral vascular accidents (strokes)

Pathophysiology
Lagophtalmos can arise from a malfunction of the Facial nerve. Lagopthalmos can also occur in comatose patients having a decrease in orbicularis tone, in patients having palsy of the facial nerve (7th cranial nerve), and in people with severe skin disorders such as ichthyosis.

Risk Factors:
Your eyelids play a crucial role in protecting and providing nourishment to your eyes. When blinking or eyelid closure function is lost, the health of your eyes can be at risk. Many experts have noted several complications associated with lagophthalmos:

*Severe dry eye and discomfort
*Corneal ulceration (damage to the cornea-the clear tissue covering the front of your eye)
*Decrease or loss of vision
*Unsatisfactory appearance

Diagnosis:

A diagnosis can usually be made with a focused history and slit lamp examination. Treatment is multipronged and may include minor procedures or ocular surgery to correct the lid malposition; natural, topical or oral agents; and punctal plugs to manage ocular surface effects. Correct and timely diagnosis allows greater opportunity for relief of patient suffering and prevention of severe ocular surface pathology, as well as educated planning for future ocular surgical procedures.

Treatment:
Today, lagopthalmos is most likely to arise after an inexperienced or unwise cosmetic/plastic surgeon performs an overenthusiastic upper blepharoplasty, which is an operation performed to remove excessive skin overlying the upper eyelid (suprapalpebral hooding) that often occurs with aging. This can appreciably improve the patient’s appearance, and make the patient look younger. If, however, excessive skin is removed, the appearance is unnatural and “lagopthalmos” is one of the signs of such excessive skin removal.

It all begins with your diagnosis of your condition by your ophthalmologist. Typically, if your paralysis is expected to last less than six months, your doctor will recommend the use of drops and ointments throughout the day to help maintain a well-nourished eye.

If your paralysis is deemed permanent or persists without improvement, your surgeon may want to perform surgery to control the paralysis and provide a more natural function to your eyelid. The most common surgical procedure involves the placement of a small, pure-gold eyelid weight into your eyelid. This procedure very simple and is typically performed under local anesthesia in an outpatient setting.

How Does The Gold Eyelid Weight Work?
It’s very simple. The appropriate implant ‘weight’ will be selected your physician. When implanted into your lid margin, the weight will essentially allow earth’s gravity to gently pull your eye closed when your muscles relax. However, this will not affect your ability to open your eye…. when you tense the muscle, your eyelid will open normally.

CLICK & SEE

Is Gold A Safe Material?
Each weight is made from 99.99% gold (pure gold). Pure gold is an excellent material because it is biologically stable and inert. Because the gold will never break down, your surgeon can always remove it if deemed necessary. Gold has been used for decades for the treatment of lagophthalmos and is recognized by experts as an extremely safe and effective device material. If you have a known sensitivity or allergy to gold, notify your physician before surgery.

What Happens During Surgery? How Is The Gold Weight Implanted?
Gold eyelid weight surgery is usually performed under local anesthesia in an outpatient setting. Previous to the day of the surgery, your physician will have selected the appropriate gold weight size for your specific needs.

During the procedure, your physician will first make a small incision in your eyelid, just above your eyelashes. This incision will allow your physician to create a small pocket inside your lid for the gold implant to rest. The weight will be secured to your lid with sutures. Each weight contains small channels or grooves to house the sutures below the surface of the implant. The incision is closed with sutures. A protective pad will be applied to cover your eyelid.

What Happens After Surgery? What Should I Expect Regarding The Function And Appearance Of My Eyelid?
As always, your condition and progress will be closely monitored by your physician. Following the removal of your eye protection, you should be able to experience normal blinking and eyelid closure function.

Like any surgery, the incision will take time to heal. If you experience significant discomfort or swelling around the incision, contact your physician immediately.

Any questions or concerns you have about your surgery can best be answered by your surgeon. You can best insure the best outcome for your procedure by carefully following your surgeon’s instructions.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://en.wikipedia.org/wiki/Lagophthalmos
http://www.iopinc.com/patient_link/lagophthalmos.asp
http://www.drugs.com/dict/lagophthalmos.html
http://www.ncbi.nlm.nih.gov/pubmed/16671223

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