View 2019 Abstracts

Incomplete eyelid closure, or lagophthalmos, as well as the loss of blink caused by an interruption to the nerve supply to orbicularis oculi, can lead to exposure keratopathy. This can have devastating consequences as a result of corneal breakdown, ulcers, and even perforation.

External eyelid weights are a temporary solution that work to reduce exposure by restoring some element of eyelid function. It is attached to the upper eyelid with adhesive. This can avoid more long lasting or invasive procedures such as botulinum toxin, tarsorrhaphy and/or implantation of gold weights into the upper eyelid – especially in patients who are poor surgical candidates, or those who refuse surgery.

Despite being simple to administer and use, relatively cheap, and easily available, to date the use of external eyelid weights has been very limited.

In this series of seven patients we will highlight the varied applications and effectiveness of external eye lid weights, especially in patients with ‘locked-in syndrome’, Parinaud’s dorsal midbrain syndrome and Bell’s Palsy – some of whom have been extremely proactive and motivated, managing the need to avoid surgery altogether.

External eyelid weights should play an essential role in the management of patients with ocular exposure, not only as a trial before surgical implantation of lid weights, but also as a longer-term treatment for ocular exposure.