Nocturnal Lagophthalmos: Sleeping with Eyes Open

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Nocturnal lagophthalmos is a condition in which the eyes stay open or don’t close all the way during hours of sleep. Lagophthalmos is quite common in children; older adults sometimes have this condition and it is a little more serious than with ch

Lagophthalmos is a fairly common disorder with children. You may have noticed that your children sleep with their eyes open or that their eyes don’t fully close when they sleep. You may have been told that you do this. I was told that my eyes didn’t fully close when I slept as a kid. I must have outgrown it, because no one has told me that since I have grown up.

Adults that have lagophthalmos may have a harder time of it because they experience dry eyes during the day time when they are awake. It’s painful because during sleep the eyes are open to the air, which dries out the corneas. It can be painful while the eyes try to create enough tears to lubricate the eyes properly. Sometimes with older patients, the condition is compounded by dry eye syndrome.

What causes nocturnal lagophthalmos?

Nocturnal lagophthalmos can be caused by an infection, by trauma to the eye, or facial paralysis such as with Bell’s palsy. It may also be caused by a stroke. The function of the eyelids is to protect the eye and to spread lubrication to the surface of the cornea and sclera.  Your eyelids are a barrier to your eyes while you sleep; when your eyes fail to close properly, they can become exposed to germs and anything in the environment. Your eyes could get scratched as you move around on the pillow at night. This condition may be caused by other procedures that have been done to the eyelids in the past, such as with eyelid surgery. Certain sedating medications and also excessive use of alcohol may also cause nocturnal lagophthalmos.

Does it hurt to have nocturnal lagophthalmos?

It can hurt to have this condition. When you wake up, your eyes will most likely feel dry and itchy. When you try to move your eyes under your lids, you may feel pain and scratchiness. When I had this as a kid I was very photophobic. It is fairly common for people with Bell’s palsy to have this disorder. Sometimes, people who have had Bell’s palsy in the past can no longer close one of their eyes during hours of sleep. Stroke victims who have suffered facial paralysis may also suffer from nocturnal lagophthalmos, even after they have recovered from a stroke.  

How is nocturnal lagophthalmos treated?

There isn’t much to be done to stop the eyes opening at night. However, the treatment of choice is to tape the eyelids closed at night when you sleep. It’s also necessary to use eye drops or an eye gel at night. Your doctor may suggest an over-the-counter brand of eye preparation, or prescription medications may be used. A topical antibiotic may also be used if you are susceptible to an eye infection.

If you have a severe case of lagophthalmos, surgery can be done. The ophthalmic surgeon can implant a tiny gold weight into the eyelid which will aid gravity in allowing the eyelid to close and blink.


Nocturnal lagophthalmos

Personal experience 


carol roach
Posted on May 14, 2012
Ron Siojo
Posted on May 14, 2012
Kaleidoscope Acres
Posted on May 13, 2012