Medical treatment consists of improving the quantity, quality, and stability of the tear film. Treatment can be divided into medical and surgical modalities. Therefore the patient needs to regain an appearance acceptable to themselves. Any asymmetry in a person's face will likely have a psychological impact. The purpose of treating lagophthalmos is two-fold: to prevent further corneal exposure and to improve eyelid function. There are many etiologies associated with facial nerve paralysis hence a detailed history and workup are necessary to determine treatment of the underlying cause. The primary cause of lagophthalmos is facial nerve paralysis, which leads to paralytic lagophthalmos. Therefore it is essential to recognize the signs of lagophthalmos early and investigate the causes and begin treatment. This can progress to corneal ulceration and perforation. Patients who are unable to blink and completely close their eyes are at risk of corneal exposure, evaporation of the tear film, and subsequent exposure keratopathy. A full eyelid closure with a normal blink reflex is necessary for the maintenance of a stable tear film and healthy ocular surface. Lagophthalmos describes the incomplete or abnormal closure of the eyelids.
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