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An unusual cause of lagophthalmos

Authors
Journal
Oman Journal of Ophthalmology
0974-620X
Publisher
Medknow Publications
Publication Date
Volume
3
Issue
1
Identifiers
DOI: 10.4103/0974-620x.60020
Keywords
  • Clinical Images
Disciplines
  • Agricultural Science
  • Medicine

Abstract

A 25-year-old youth presented with inability to close his right upper eyelid completely since two days following suturing of an eyebrow laceration, which was done elsewhere. The wound was due to impact against the handle bar following a bicycling accident. On examination, there was wound in his right eye brow, which was closed with continuous interlocking sutures [Figure 1], the bites of which were away from the wound margins. Further, the suture bites of the lower wound margins were incorporating the skin and subcutaneous tissue of the upper eyelid resulting in traction of the eyelid and causing lagophthalmos. There was periorbital edema and subconjunctival hemorrhage with normal visual acuity and the opposite eye was normal. A decision was made to revise the suturing so as to correct the ′iatrogenic lagophthalmos′. Under local anesthesia, with aseptic precautions, the primary suture was removed and the wound re-opened. As soon as the constricting sutures were removed and the eye lid released, it was seen fully closing the eyeball. After minimal debridement and saline irrigation, the wound was closed meticulously with proper alignment of the matching points and anatomical landmarks on either side of the wound with 4-0 vicryl sutures for the subcutaneous tissue and 5-0 nylon for the skin restoring the cosmetic appearance of the face and correcting the iatrogenically created lagophthalmos [Figure 2]. Figure 1 Irregular hemostatic sutures of the eye brow causing lagophthalmus Figure 2 Correction of lagophthalmus after revision of hemostatic suture The word lagophthalmos is derived from the Greek word for hare eye.[1] It is a condition characterized by inability of the eyelid to close the eyeball completely. Lagophthalmos secondary to cranial nerve VII paresis or palsy may be idiopathic [Bell′s palsy], congenital [Moebius syndrome], or secondary to trauma [facial nerve injury], infection [Lyme′s disease], or iatrogenic

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