Evie Summers
Nocturnal lagophthalmos is a condition that causes people to sleep with their eyes open. While this may not be immediately obvious to the person with the condition, it can lead to several health issues over time. One in a million people suffer from Ablepharon-macrostomia syndrome (AMS), a rare genetic disorder that prevents the eyelids from developing properly. This leaves the eyes without protection and can cause blurry vision, dryness, and irritation. Treatments include eye drops, ointments, weighted eyelid implants, and, in more severe cases, surgery.
| Characteristics | Values |
|---|---|
| Condition | Nocturnal lagophthalmos |
| Symptoms | Blurry vision, dry eyes, sensitivity to light, red eyes, irritation, a feeling that something is stuck in the eye |
| Causes | Genetic disorder, problems with eyelids at birth, conditions affecting nerves in the face (e.g., stroke, serious injury, surgery, Bell's palsy), Graves' disease |
| Complications | Eye dryness, poor vision or loss of vision, eye irritation, restlessness during sleep |
| Treatments | Eye drops, ointments, eyelid weights, medical tape, surgery, weighted eyelid implants |
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What You'll Learn
Nocturnal lagophthalmos
- Facial paralysis or nerve damage: Loss of function in the facial nerve, particularly the orbicularis oculi muscle responsible for closing the eyelids, can lead to nocturnal lagophthalmos.
- Trauma or surgery: Structural problems or injuries to the eye area can result in mechanical lagophthalmos.
- Eyelid damage: Conditions such as lax eyelid syndrome (LES) or floppy eyelid syndrome (FES) can affect the elasticity and movement of the eyelids.
- Medical conditions: Disorders like Stevens-Johnson syndrome, which causes skin blistering, or autoimmune disorders such as Guillain-Barré syndrome, can contribute to nocturnal lagophthalmos.
- Infections, tumours, and sun damage: Various infections, the presence of tumours, and sun damage to the skin around the eyes can also play a role in the development of nocturnal lagophthalmos.
- Artificial tears and ointments: Applying artificial tears throughout the day and protective ointments to the cornea can help prevent dryness and scratching.
- Moisture goggles: Wearing moisture goggles while sleeping can help protect and moisturize the eyes.
- Humidifier: Using a humidifier near the bed can provide additional moisture to the eyes.
- Weights and tape: Small weights or surgical tape can be used on the outside of the eyelids to keep them closed during sleep.
- Eye mask: Wearing an eye mask during sleep can improve eye hydration.
- Lifestyle changes: Avoiding sleeping pills and other behaviours that may contribute to the condition is recommended.
- Surgery: In severe cases, surgery may be an option, involving the insertion of a gold implant above the lashes to weigh down the eyelid.
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Eye irritation and dryness
Dry eye is a common condition that can cause eye irritation and discomfort. It occurs when the tear film, which normally keeps the surface of the eyes lubricated, becomes disrupted. This can be due to a variety of factors, including age, gender, medical conditions, medication, and environmental factors.
Age is a contributing factor to dry eyes, with tear production naturally diminishing as individuals get older. People over the age of 50 are more likely to experience dry eyes, and the condition becomes more common with advancing age.
Gender also plays a role, as women tend to be more susceptible to dry eyes due to hormonal changes related to pregnancy, birth control pills, and menopause. These hormonal fluctuations can affect tear production and eye hydration.
Certain medical conditions, such as Sjogren's syndrome, allergic eye disease, rheumatoid arthritis, lupus, scleroderma, and thyroid disorders, can also lead to dry eyes. Additionally, specific medications, including antihistamines, decongestants, hormone replacement therapy, antidepressants, and medicines for high blood pressure, acne, and Parkinson's disease, can have dry eyes as a side effect.
Environmental factors, such as sleeping with a fan blowing on your face or spending too much time on digital screens, can also contribute to eye dryness and irritation.
To manage eye irritation and dryness, there are several options available. Artificial tear drops and ointments are commonly used to treat mild cases of dry eyes. It is important to try different products to find the one that works best for you. For more severe or chronic cases, temporary punctal plugs or procedures like cautery may be recommended to block the tear ducts and increase tear levels in the eyes.
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Blurry vision
Another cause of blurry vision is cornea swelling, which can be triggered by sleeping face down, a condition known as floppy eyelid syndrome (FES). FES is more common in obese men and can cause tearing, eye burning, and cloudy vision in the mornings. In addition, people with obstructive sleep apnea, a condition characterised by shallow or stopped breathing during sleep, may also experience blurry vision due to associated conditions such as dry eye syndrome and floppy eyelid syndrome.
Allergies are another common cause of blurry vision. Allergens such as dust mites, pet dander, or pollen can cause itchy, swollen, and watery eyes, as well as dry eyes, resulting in blurry vision when you wake up. Eye allergies may also be caused by an allergy to detergent used to wash bedding.
Finally, blurry vision can result from sleeping without removing contact lenses. Contact lenses can accumulate debris over time, leading to eye irritation and increased risk of eye infections, both of which are associated with blurry vision.
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Eye scarring
The eyes are complex organs, and it is important to take care of them. The eyes have a protective outer layer, the epithelium, which helps to defend against dirt, dust, and germs. However, the cornea can still be damaged, and this can lead to corneal scarring.
Corneal scarring is often the result of an eye injury, such as a deep scratch, laceration, or burn. It can also be caused by improper contact lens use, or cosmetic treatments like eyelash lifts. In addition, certain eye conditions can lead to corneal scarring. These include corneal dystrophies, which are hereditary diseases that affect the cornea and can cause issues such as hazy or blurry vision, light sensitivity, and even blindness. Other conditions that can result in corneal scarring include keratoconjunctivitis, an inflammation of the eye's superficial cornea and conjunctiva; trachoma, a bacterial infection that can cause corneal inflammation and eyelashes to turn inwards; and Stevens-Johnson syndrome, which causes painful blisters and lesions on the skin and mucous membranes, potentially leading to corneal scarring.
The diagnosis of corneal scars is typically done as an outpatient. An ophthalmologist will discuss the patient's eye injuries, symptoms, and medical history. They will then perform an eye exam, using tools like a slit lamp or ophthalmoscope to get a better view of the eye and look for any abrasions or irritating debris. A technique called fluorescein eye stain may also be used, where dyed eye drops and a blue light help visualize the cornea.
Treatment options for corneal scarring depend on the severity of the scarring and the patient's specific situation. One option is laser surgery, which uses UV light to treat the scarring.
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Treatments: eye drops, ointments, eyelid weights, medical tape, surgery, weighted eyelid implants
Sleeping with your eyes open is generally not recommended due to the potential negative long-term health effects. However, for those who have no choice but to sleep in this manner, there are several treatment options available to manage the condition and prevent eye damage.
Eye Drops
Lubricating eye drops can be prescribed by a doctor to treat dryness in the eyes, encouraging tear production and reducing discomfort.
Ointments
Doctors may also prescribe ointments or artificial tears to help moisturize the eyes during sleep, reducing the risk of infection and other complications.
Eyelid Weights
External eyelid weights can be worn on the upper eyelids during sleep to help keep the eyes closed and protected. This treatment option is often recommended for those with lagophthalmos.
Medical Tape
Surgical or medical tape can be applied to the eyelids to keep the eyes closed during sleep. This method provides a temporary solution to help train the eyelids to close naturally.
Surgery
In more severe cases, surgery may be required to address the underlying cause of the issue. For example, the insertion of a gold weight implant in the upper eyelid is a common surgical treatment for lagophthalmos, helping the eyelids close without obstructing vision.
Weighted Eyelid Implants
These implants are a type of surgical intervention where a small weight is inserted into the upper eyelid to assist in keeping the eye closed during sleep. This treatment aims to protect the cornea and maintain eye health without impairing vision.
It is important to consult a medical professional for a proper diagnosis and treatment plan as the underlying causes of sleeping with eyes open can vary.
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Frequently asked questions
Nocturnal lagophthalmos.
Blurry vision, dry eyes, and light sensitivity are all common symptoms of nocturnal lagophthalmos.
Nocturnal lagophthalmos can be caused by a variety of factors, including genetic disorders, problems with the eyelid, or conditions affecting the nerves in the face.
Treatments for nocturnal lagophthalmos include eye drops, ointments, eyelid weights, medical tape, and surgery.
Sleeping without eyelids can lead to eye dryness and irritation, which can cause poor vision or even complete loss of vision over time.
