Lagophthalmos: An etiological lookout to frame the decision for management
Purpose: To describe the etiology, clinical profile, duration of lagophthalmos cases and thereby, framing a decision for the management based on the severity of Exposure keratitis (EK), Facial palsy (FP) with each etiology and to describe the outcome of the management options. Methods: The method wa...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2022-01-01
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| Series: | Indian Journal of Ophthalmology |
| Subjects: | |
| Online Access: | http://www.ijo.in/article.asp?issn=0301-4738;year=2022;volume=70;issue=8;spage=3077;epage=3082;aulast=Rita |
| _version_ | 1811313218659811328 |
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| author | M Rani H Rita M Deepa V C Gitanjali S R Tinu B Subbulakshmi D Sujitha Gopinayik Palthya M Saradha T Vedhavalli B Sowmiya R Akalya L S Mathivadhani M Uma R Bhavani Joy R Violet |
| author_facet | M Rani H Rita M Deepa V C Gitanjali S R Tinu B Subbulakshmi D Sujitha Gopinayik Palthya M Saradha T Vedhavalli B Sowmiya R Akalya L S Mathivadhani M Uma R Bhavani Joy R Violet |
| author_sort | M Rani H Rita |
| collection | DOAJ |
| description | Purpose: To describe the etiology, clinical profile, duration of lagophthalmos cases and thereby, framing a decision for the management based on the severity of Exposure keratitis (EK), Facial palsy (FP) with each etiology and to describe the outcome of the management options. Methods: The method was a prospective review of 120 lagophthalmos cases treated at a single tertiary center from January 2018 to January 2019. The main outcome measures were analysing the association between age, etiology, duration and management of lagophthalmos. Results: Of the 120 patients studied, paralytic etiology was noted in 86 and eyelid etiology in 34 patients. The percentage of various lagophthalmos etiology documented were Bell's palsy (35.83%), lagophthalmos in ICU patients (15%), traumatic facial palsy(FP) (10.80%), stroke associated FP (6.67%), infection associated FP (6.67%), iatrogenic FP, cicatricial lagophthalmos (5%), lagophthalmos post eyelid surgeries (5%), neoplastic FP(3.33%), congenital FP (1.67%), proptosis induced lagophthalmos (1.67%), floppy eyelid syndrome induced lagophthalmos (0.83%) and lid coloboma associated lagophthalmos (0.83%). A statistically significant correlation was noted between exposure keratitis and age, with an increased prevalence age advances. The management showed significant variation with individual etiology, with some etiologies unquestionably requiring surgical management. Surgical management is crucial as the duration of lagophthalmos increases more than 6 weeks, EK involving pupillary axis and poor FP recovery. Conclusion: This study concludes that the conservative management was sufficient in all cases when the duration is less than 1 week, Exposure keratitis not involving the pupillary axis (EK< Grade II) and FP with good functional recovery ( FP < Grade III). The predominant causes being Bell's palsy, lagophthalmos in ICU patients and vascular FP. Whereas, cases with poor functional recovery of facial palsy(FP) and permanent eyelid deformation require definitive surgical management like Traumatic FP & cicatricial lagophthalmos. |
| first_indexed | 2024-04-13T10:49:59Z |
| format | Article |
| id | doaj.art-4c6c01f3022d403aa0ecc05cf72f1f26 |
| institution | Directory Open Access Journal |
| issn | 0301-4738 1998-3689 |
| language | English |
| last_indexed | 2024-04-13T10:49:59Z |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Ophthalmology |
| spelling | doaj.art-4c6c01f3022d403aa0ecc05cf72f1f262022-12-22T02:49:41ZengWolters Kluwer Medknow PublicationsIndian Journal of Ophthalmology0301-47381998-36892022-01-017083077308210.4103/ijo.IJO_3017_21Lagophthalmos: An etiological lookout to frame the decision for managementM Rani H RitaM DeepaV C GitanjaliS R TinuB SubbulakshmiD SujithaGopinayik PalthyaM SaradhaT VedhavalliB SowmiyaR AkalyaL S MathivadhaniM UmaR BhavaniJoy R VioletPurpose: To describe the etiology, clinical profile, duration of lagophthalmos cases and thereby, framing a decision for the management based on the severity of Exposure keratitis (EK), Facial palsy (FP) with each etiology and to describe the outcome of the management options. Methods: The method was a prospective review of 120 lagophthalmos cases treated at a single tertiary center from January 2018 to January 2019. The main outcome measures were analysing the association between age, etiology, duration and management of lagophthalmos. Results: Of the 120 patients studied, paralytic etiology was noted in 86 and eyelid etiology in 34 patients. The percentage of various lagophthalmos etiology documented were Bell's palsy (35.83%), lagophthalmos in ICU patients (15%), traumatic facial palsy(FP) (10.80%), stroke associated FP (6.67%), infection associated FP (6.67%), iatrogenic FP, cicatricial lagophthalmos (5%), lagophthalmos post eyelid surgeries (5%), neoplastic FP(3.33%), congenital FP (1.67%), proptosis induced lagophthalmos (1.67%), floppy eyelid syndrome induced lagophthalmos (0.83%) and lid coloboma associated lagophthalmos (0.83%). A statistically significant correlation was noted between exposure keratitis and age, with an increased prevalence age advances. The management showed significant variation with individual etiology, with some etiologies unquestionably requiring surgical management. Surgical management is crucial as the duration of lagophthalmos increases more than 6 weeks, EK involving pupillary axis and poor FP recovery. Conclusion: This study concludes that the conservative management was sufficient in all cases when the duration is less than 1 week, Exposure keratitis not involving the pupillary axis (EK< Grade II) and FP with good functional recovery ( FP < Grade III). The predominant causes being Bell's palsy, lagophthalmos in ICU patients and vascular FP. Whereas, cases with poor functional recovery of facial palsy(FP) and permanent eyelid deformation require definitive surgical management like Traumatic FP & cicatricial lagophthalmos.http://www.ijo.in/article.asp?issn=0301-4738;year=2022;volume=70;issue=8;spage=3077;epage=3082;aulast=Ritaexposure keratitisfacial palsylagophthalmoslateral tarsorrhaphy |
| spellingShingle | M Rani H Rita M Deepa V C Gitanjali S R Tinu B Subbulakshmi D Sujitha Gopinayik Palthya M Saradha T Vedhavalli B Sowmiya R Akalya L S Mathivadhani M Uma R Bhavani Joy R Violet Lagophthalmos: An etiological lookout to frame the decision for management Indian Journal of Ophthalmology exposure keratitis facial palsy lagophthalmos lateral tarsorrhaphy |
| title | Lagophthalmos: An etiological lookout to frame the decision for management |
| title_full | Lagophthalmos: An etiological lookout to frame the decision for management |
| title_fullStr | Lagophthalmos: An etiological lookout to frame the decision for management |
| title_full_unstemmed | Lagophthalmos: An etiological lookout to frame the decision for management |
| title_short | Lagophthalmos: An etiological lookout to frame the decision for management |
| title_sort | lagophthalmos an etiological lookout to frame the decision for management |
| topic | exposure keratitis facial palsy lagophthalmos lateral tarsorrhaphy |
| url | http://www.ijo.in/article.asp?issn=0301-4738;year=2022;volume=70;issue=8;spage=3077;epage=3082;aulast=Rita |
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