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Lagophthalmos is the inability to close the eyelids completely. [1] 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.
Despite the gains the patient can obtain from the surgeries, there are risk factors. After the surgery, the patient may experience asymmetrical (uneven) eyelids. If the surgery is not done carefully, the patient may experience dry eyes because the eye is no longer closing fully.
The exact cause of ALO is not yet fully understood. Despite its name, it is not a true apraxia, but thought to be due to a supranuclear origin of abnormal neuronal activity. Voluntary eyelid opening involves the simultaneous activation of the levator palpebrae superioris muscle and the inhibition of the orbicularis oculi muscle.
Blinking is a bodily function; it is a semi-autonomic rapid closing of the eyelid. [1] A single blink is determined by the forceful closing of the eyelid or inactivation of the levator palpebrae superioris and the activation of the palpebral portion of the orbicularis oculi, not the full open and close.
General anaesthesia reduces the tonic contraction of the orbicularis oculi muscle, causing lagophthalmos i.e. the eyelids do not close fully in 59% of patients. [3]In addition, general anaesthesia reduces tear production and tear-film stability, resulting in corneal epithelial drying and reduced lysosomal protection.
Blepharospasm usually begins with occasional twitches of both eyelids, which progress over time to forceful and frequent spasms and contractions of the eyelids. In severe episodes, the patient cannot open their eyelids (apraxia), which severely limits their daily activities. Prolonged closure of the eyelids may result in functional blindness. [4]
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Affected eyes do not have the ability to open and close properly. In severe cases, a person is not able to open the affected eyelid. [1] Ptosis eye crutches are tools installed to existing eyewear that support the affected eyelid, enabling the eyelid to stay open and allowing an individual to see.