Simply put, Lagophthalmos is the inability to close your eyelid, or blink. This condition occurs when the muscle (called the orbicularis) that controls the "blink" function becomes paralyzed. Separate muscles are used to open and close the lids. When you have lagophthalmos, the orbicularis that closes your eyelid does not function properly. Usually, only one eye is affected.

Eyelids can be thought of as protective covers for your eyes. Normal closure and blinking of your eyelids is important to the health of your eyes.

With blinking, your eyes are constantly being bathed by a thin film of watery fluid (the tears). Your tears also flush out and wash away foreign bodies that get past your eyelids and lashes. Each blink of your eyelids applies a new layer of tears and prevents the eyes from drying out.

When the blink function is lost, the eye can become dry, damaging the cornea. This may lead to discomfort, pain and even a decrease in, or loss of vision.

How can lagophthalmos be treated?

If your physician believes the paralysis of the orbicularis muscle is temporary, he or she may recommend you wear a protective eye patch and apply moisturizing drops to your eye at regular intervals until the paralysis disappears. If paralysis persists, it may be necessary to place a small weight (gold implant) into your eyelid to allow normal closure and blinking.

How does the weight work?

An eyelid implant is a small gold plate shaped to fit your eye. It is thin, with smooth, tapered edges designed to make it fairly inconspicuous when it is implanted into your eyelid.

The weight of the implant is precisely calibrated to allow gravity to pull your eyelid closed when you relax the muscle (levator) that lifts your upper eyelid. When you tense the muscle again, the eyelid opens normally.

Gold is the ideal material for these implants because gold does not corrode, it is heavy and it is virtually inert, making it very unlikely to irritate the tissues in your eyelid.

What is the procedure for implanting an eyelid weight?

First, your physician will determine the weight that gives you the optimal "blink" function. This is achieved by attaching trial weights to the outside of your eyelid with an adhesive strip.

You will be asked to look up and down while your physician observes the position of your eyelid. When the best result is achieved, your physician will note the weight of the trial piece. This will be the weight of the implant that will be placed into your eyelid.

Next, an appointment will be made for your procedure, which will often be done on an out-patient basis. Local anesthesia is normally used. You will arrive a few hours before the procedure, remain in recovery for several hours following the procedure, and leave for home before the end of the day. You may be required to temporarily wear a patch over your eye to protect it.

During the procedure, your physician will make an incision in the outer surface of your eyelid and create a small pocket where the implant will be placed. The implant will be held in position inside the pocket with sutures. The incision is then sutured closed and an antibiotic ointment is placed on the wound before a pad is applied.

Your doctor will schedule an appointment about a week after your procedure to check your progress.

Once you remove your patch, you should be able to close your eyelid normally. The incision is hidden in the fold (crease) of your upper eyelid and is not noticeable. In some patients with deeply set eyes and thin eyelids, the implant and the incision may be somewhat more apparent.

The slight redness of the healed incision line should fade over time to become virtually indiscernible.

What problems should I watch for?

Every surgical procedure carries some risk. After the procedure, if you experience unexpected swelling or inflammation, contact your physician. In rare cases, the implant may become displaced or can erode through the skin. These complications can usually be handled efficiently.

The eyelid weight is made of 99.99% pure gold. If you have a known sensitivity to gold, a gold weight should not be implanted. However, for most people, the risk of a reaction to gold implants is very low and the advantages of use generally outweigh these risks.

Your physician can answer any additional questions you may have regarding this procedure.