If you've ever seen someone sleeping with his eyes partially open, you know it can be jarring. The image of an open-eyed sleeper can be corpse-like, and you may find yourself tempted to try to close the eyes without waking the person.

Lagophthalmos, or the inability to fully close one's eyes, can be caused by a variety of reasons. Facial nerve problems, thyroid disease, previous eye surgery, or even a brain tumor might be behind the problem. Some people cannot close their eyes all the way at any time, while others experience the problem only while sleeping. This so-called nocturnal lagophthalmos can be hard to diagnose, especially if the sleeper lives alone or shares a bed with a partner who sleeps when he does. Once the problem becomes evident, though, an optometrist or ophthalmologist can do an exam to determine the extent and source of the problem.

But is it a problem? Some people with nocturnal lagophthalmos are completely normal and healthy, and the only issue associated with the condition is dry eyes (and perhaps a spooky appearance at night). Other people have significant eye pain upon awakening and may suffer from sleep disruptions that impact their health. People with underlying medical issues, such as diabetes or thyroid disease, need to have their lagophthalmos monitored and possibly treated. People considering LASIK surgery to correct their vision also need to have the condition evaluated, as the surgery can significantly worsen dry eyes.

Treating nocturnal lagophthalmos may be as easy as prescribing ointment for dry eyes or as involved as performing surgery to correct an eyelid deformity. Other options include:

Taping eye lids. Patients use a surgical tape to keep their eyes closed during sleep.

Wearing nighttime moisture goggles. These mask-like goggles provide a moist environment for the eyes to prevent dryness.

Having gold weights implanted. An eye surgeon places small gold weights inside the eyelids to help close them. Although this procedure typically has good results, it can potentially cause one lid to hang lower than the other, and can lead to blurry vision.




American Society of Cataract & Refractive Surgery