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What Is Lagophthalmos?

Lagophthalmos refers to the incomplete closure of the eyelids and can produce symptoms similar to dry eye syndrome, such as dry, itchy, watery eyes. In extreme cases, it can cause corneal ulcers.

There are several types of lagophthalmos, ranging from mild to severe. Common symptoms include:

  • Increased tearing
  • Dryness
  • Irritation
  • The sensation that something is stuck in the eye
  • Blurred vision
  • Eye pain, especially in the morning

A visit with Dr. Michael Antoine, O.D. can determine if lagophthalmos is causing or contributing to your dry eye symptoms.

Types of Lagophthalmos

grayscale photo of woman covering her face by her handBlink Lagophthalmos

When the eyelids don’t fully close during a blink, this is called “blink lagophthalmos.” Blinking keeps the eyes lubricated by spreading the tear film evenly along the eyes’ surface. An incomplete blink can lead to dry spots on the eye and other uncomfortable dry eye symptoms. Colliding eyelashes or tasks that require a high level of focus (such as working on a computer) can contribute to blink lagophthalmos.

Nocturnal Lagophthalmos

Nocturnal lagophthalmos occurs during sleep, so people with this condition may be unaware they have it. One common cause of this type of lagophthalmos is a decrease in fatty tissue behind the eyeball. Less cushioning causes the eye to sink further into the socket, making it more difficult for the lids to completely close. The fatty tissue can deteriorate for several reasons, including the presence of an autoimmune disease.

Paralytic Lagophthalmos

Paralytic lagophthalmos results from a paralyzed cranial nerve, thus preventing the eyelids from complete closure. Paralysis of the seventh cranial nerve can be caused by Bell’s palsy, tumors, or trauma.

Iatrogenic lagophthalmos

This is when the eyes can’t fully close due to medical treatment. Medical procedures that can cause lagophthalmos include Botox injections and sutures near the eye.

How Your Eye Doctor Can Help

There are several ways to treat lagophthalmos, and sometimes surgery may be necessary. It’s best to first visit Dr. Michael Antoine, O.D. to pinpoint the cause of your symptoms and try the least invasive and safest treatments before resorting to surgery. If left untreated, lagophthalmos can result in corneal damage.

If you’re experiencing dry eye symptoms of any kind, an eye exam at Antoine Eye Care Dry Eye Center can help determine the underlying condition so that a tailor-made treatment plan can provide long-lasting relief. Dry eye relief extends far beyond the options available at your local drugstore. The friendly staff at Antoine Eye Care Dry Eye Center make it their mission to provide the highest quality care for their patients. Get the relief you seek — book your appointment today.

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Are Your Contact Lenses Causing Dry Eye?

Among the more frequent complaints, eye doctors receive from patients is that their contact lenses are making their eyes dry. While dry eye syndrome (DES) is very common among both contact lens wearers and non-wearers alike, the symptoms can be more severe and uncomfortable if you wear contact lenses. Typically, DES symptoms include irritated, red and itchy eyes.

The best way to deal with contact lens-induced dry eye syndrome is to visit Dr. Michael Antoine, O.D., so we can determine exactly why your eyes are dry and provide ways to increase your comfort while wearing contact lenses.

What Is Contact Lens-Induced Dry Eye?

The cornea, the front of your eye, is the only area of your body that receives oxygen directly from the air. One reason contact lens wearers are predisposed to dry eyes is because the contact lens on your cornea can partially block oxygen from entering the eye. Although many contact lenses are designed to allow larger amounts of oxygen to permeate the eye, wearers can still experience dry, gritty eyes, especially towards the end of the day.

Another cause of contact lens-induced dry eye is the lenses’ absorption of tears. Lenses need liquid to stay soft and maintain their shape and integrity.

This is known as contact lens-induced dry eye.

In a healthy eye, tears allow the contact lens to comfortably swim in the tear film above the cornea. A shortage of lacrimal fluid can lead to gaps in the tear film, causing the contact lens to irritate the surface of the eye. That, in turn, causes pain, redness and itchiness.

This effect can be further exacerbated if the lenses are low in quality or are poorly fitted to the eye. Such contacts absorb too much liquid from the tear film, causing the eye to lose vital moisture. This can also occur when traditional soft lenses are worn for an extended period of time.

Getting Relief for Contact-Lens Induced Dry Eye

The following can provide relief from contact lens-related dry eye.

  • Eye drops – Be sure to get eye drops that can be applied safely with contact lenses to reduce discomfort and refresh eyes. If, for any reason, the over-the-counter eye drops aren’t working, consult Dr. Michael Antoine, O.D., who can provide more effective treatment options.
  • Eye vitamins – Certain vitamins, taken orally, can increase the amount of nutrients your eyes receive. This not only improves eye health, but also increases contact lens comfort. The best eye vitamins and supplements include lutein, zeaxanthin, Vitamin A, Vitamin C and Omega-3.
  • Silicone hydrogel contact lenses – These lenses are made from the most innovative contact lens material available on the market. They are extremely breathable because they permit up to 5 times more oxygen to reach the eye than older-generation contact lenses. This allows them to be worn over a long period of time. They reduce dryness and boost comfort.
  • Low water content contact lenses It is a common misconception that the higher the water content, the more comfortable the contact lens. For certain wearers, particularly those suffering from dry eyes, it can have the inverse effect. High water contact lenses allow more oxygen to flow to the cornea but over time, as they lose liquid, they draw it from the tear film, thus exacerbating dry eye symptoms.
  • Daily disposable contact lenses – Also called dailies, these single-day contact lenses are a great option for dry eye sufferers. This is because protein deposits don’t have the time to build-up and cause discomfort, and lenses don’t dry out as a result of improper cleaning routines.
  • Scleral lenses – These large-diameter rigid gas permeable (GP) lenses vault over the entire corneal surface, ensuring that the front surface of the eyes don’t dry out. The liquid reservoir between the lenses and the cornea provides a continuous moist environment that protects the cornea and provides relief for those with dry eyes.
  • Orthokeratology – Would you like to wear contact lenses only when asleep? Orthokeratology (or ortho-k) is a gas permeable contact lens prescribed for overnight wear only. These lenses reshape the cornea while you sleep and temporarily correct nearsightedness and other refractive errors, thus enabling you to see clearly during the day without any need for contacts or glasses. This reduces contact lens-related dry eye symptoms.
  • Adhering to the hygiene routine advised by your eye doctor – Those who wear monthly lenses need to adhere to a specific hygiene routine advised by their eye doctor. If you’re using the wrong solution or not cleaning your lenses properly, this could be why you’re suffering from dry eye. Keep in mind that not all multi-purpose cleaning solutions are designed to clean silicone hydrogel contact lenses, so make sure the solution you’re using is correct.

        There is also a chance you may have sensitive eyes and that your dry eye symptoms may be an adverse reaction to the preservatives in the solution. If your eyes feel irritated, yet you are using your regular cleaning solution, speak to Dr. Michael Antoine, O.D., who will recommend a preservative-free lens solution for improved comfort.

        Tips to Avoid Dry Eye When Wearing Contact Lenses

        Dry Eye Girl 640×350To prevent eye dryness or inflammation, we recommend the following tips:

        • Make sure you’ve been fitted for your contact lenses by an eye doctor, as the eye practitioner can determine the exact strength and curvature of the contact lenses you need, and recommend the most suitable lenses for your eyes.
        • Regularly get your eyes examined for vision acuity and general ocular health. Contact Antoine Eye Care Dry Eye Center today for a comprehensive eye evaluation.
        • Purchase high-quality lenses and make sure they have good oxygen permeability. Lenses with hyaluronan, particularly silicone hydrogel lenses, are excellent for people prone to developing dry eyes. Hard lenses also come highly recommended, as they draw very little liquid from the tear film.
        • Until you find a better solution, do not wear contact lenses for extended periods. If you suffer from dry eyes, it is best that you only wear them for a few hours and on special occasions, such as for an outing or to play sports. Avoid wearing contact lenses when watching TV or working at your computer, as these place a strain on your eyes.
        • Make sure to dispose of lenses every day, fortnightly or monthly, depending on what your eye doctor recommends. Your contact lens containers should also be changed every few weeks to prevent any germ build-up.
        • Avoid wearing contact lenses when ill with a cold or the flu, as there is an increased risk of transferring germs into the eyes. Remove contact lenses if you have an eye infection like conjunctivitis (or pink eye), as germs can build up extremely well underneath them.

        If you wear contact lenses and struggle with dry eyes, ask your Antoine Eye Care Dry Eye Center eye doctor about scleral lenses. Dr. Michael Antoine, O.D. will patiently assess and explain your condition to you, and will provide solutions and treatments for optimal visual clarity and comfort. Fortunately, there’s a vast array of contact lens types and brands available, so those who fear that they may have to discontinue contact lens wear altogether need not worry.

        Call the Antoine Eye Care Dry Eye Center today to schedule your consultation.

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        Dry Eye After LASIK

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        Dry Eye After LASIK

        Many individuals with refractive errors like nearsightedness choose LASIK (laser-assisted in situ keratomileusis) surgery to correct their vision due to its safety and effectiveness. But dry eyes are a remarkably common after-effect of LASIK surgery, affecting up to 95% of patients who’ve undergone this procedure. In fact, dry eye symptoms are the primary reason for patient dissatisfaction after LASIK. Although symptoms of dry eye syndrome (DES) most commonly occur in the immediate postoperative phase and are generally only temporary in nature, some individuals develop chronic and severe DES that can negatively impact their quality of life.

        twin femalesWhat Is DES?

        Dry eye syndrome is a multifactorial condition that is characterized by a chronic lack of ocular lubrication, which can be caused by poor quality tears, insufficient tears, pollution, allergies, or irritants.

        Some symptoms of DES include, but are not limited to:

        • Redness
        • A feeling of dryness or irritation
        • Grittiness – the sensation that something is stuck in the eye
        • Fatigued eyes
        • Blurred vision
        • Watery eyes
        • Photophobia (light sensitivity)

        To learn more about DES, visit our main Dry Eye page.

        How Can LASIK Lead To Dry Eye?

        During the LASIK procedure, some of the cornea’s nerves are cut, leading to reduced corneal sensitivity. The eye may respond to the decreased sensitivity by not sensing the need for lubrication, thereby producing fewer tears. This reduction in tear production is usually the culprit in post-LASIK DES.

        LASIK surgeons are now aware that healthy tears promote healing following surgery. For this reason they perform certain screening tests prior to the procedure to ensure that DES will not significantly interfere with the outcome of LASIK.

        What Are Risk Factors For Post-LASIK Dry Eye?

        The following conditions increase a person’s risk of developing DES after undergoing LASIK surgery:

        • Having a high degree of myopia
        • Being above the age of 50
        • Being a female, especially post-menopausal
        • Having an autoimmune disease, such as Sjorgen’s syndrome
        • Living in a dry climate

        How We Can Help Manage Your Symptoms

        If you’ve undergone LASIK or are considering it for the future, know that we are here to help treat your DES symptoms, should any arise? At Antoine Eye Care Dry Eye Center, we provide dry eye relief to many patients who’ve had refractive surgeries and have helped make the healing process more comfortable. You don’t have to live with the discomfort of dry eye syndrome — speak with Dr. Michael Antoine, O.D. about finding long-lasting relief.

        Resources

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        Learn More About Dry Eye
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        Lagophthalmos and Dry Eye

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        Why Dry Eye Affects More Women Than Men

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        Why Dry Eye Affects More Women Than Men

        The millions of women suffering from dry eyes can tell you that dry, itchy, watery eyes are no fun. Dry eye syndrome is not just uncomfortable or a nuisance, but can also negatively impact productivity and quality of life. Dry eye tends to develop in those aged 50 and up, and affects more women than men. Below we’ll explain why it’s more prevalent among women than men.

        Dry Eye Syndrome and Women

        Dry eye syndrome (DES) is a condition characterized by dry, itchy, gritty and burning eyes. It occurs when the eye isn’t properly lubricated, either due to insufficient or poor-quality tears. Healthy tears are made up of a delicate balance of water, oil, and mucous, and any imbalance in this composition can result in dry eyes.

        The symptoms of dry-eye can range from mildly uncomfortable to incapacitating and can cause visual disturbances or corneal damage if left untreated. If you think you may have dry eyes, or experience any of the following symptoms, Dr. Michael Antoine, O.D. can offer effective long-lasting relief.

        Dry-eye symptoms include:

        • Burning or itchy eyes
        • Grittiness
        • Fatigued eyes
        • Eyes that are red and sore
        • Photophobia (light sensitivity)
        • Blurred vision
        • Watery eyes

        Why Is Dry Eye More Common Among Women?

        woman behind the flowersThe major reason that women are at risk for dry eye is due to the hormonal changes that occur throughout their lifetime. The fluctuation of estrogen, progesterone, and testosterone (among other hormones) affects tear quality and production. More specifically, high levels of estrogen and low levels of testosterone both contribute to DES.

        Women taking oral contraceptives may also experience dry eyes as a side effect. This is because the reduction in androgen levels due to the pill may impact the amount of tears produced and reduce tear-film stability.

        The hormonal changes that occur during pregnancy can also lead to DES, leading pregnant women to stop wearing eye makeup or contact lenses due to heightened eye sensitivity. Furthermore, morning sickness may contribute to dry eyes as vomiting can cause dehydration, and because the eyes are part of a whole system, a dehydrated body often means dehydrated eyes.

        Women who wear eye makeup, such as mascara and eyeliner, have an increased risk of developing dry eye due to irritating ingredients found in these products. It should also be noted that makeup removers often contain oil and harsh chemicals that can thin out the tear film covering the eye, causing the tears to evaporate prematurely.

        Though women of all ages have a higher chance of developing dry eye than men do, those over the age of 50 are more susceptible to it.

        Post-Menopausal Women and Dry Eyes

        An estimated 38% of post-menopausal women in North America use hormone replacement therapy (HRT) to manage menopausal symptoms. A common side effect of HRT is dry eye, especially if estrogen alone is administered.

        A study published in the Journal of the American Medical Association followed approximately 25,000 women over the course of 4 years to determine the relationship between HRT and dry eye syndrome. The results show that women using HRT with estrogen alone increase their risk of developing dry eye by 69%, and women who use a combination of estrogen and progesterone are 29% more likely to experience dry eye symptoms than women who don’t use HRT at all.

        The risks and benefits of HRT should be discussed with a primary caregiver or gynecologist before starting treatment, particularly if there is a history of dry eye or other ocular conditions in the family.

        Other medications popularly prescribed to patients over 50 can also contribute to dry eye symptoms, such as diuretics, antidepressants, and beta-blockers.

        Fortunately, there are steps that women can take to prevent and/or treat dry eyes.

        How Can Women Reduce Their Risk of Developing Dry Eye?

        Below are a few practical tips:

        • If you wear eye makeup, don’t apply products on the inner parts of the eyelid in order to avoid irritation.
        • Be sure to remove eye makeup before bed by using a gentle soap or paraben-free makeup remover.
        • If you use a hairdryer, try not to aim it towards the eyes, as this can cause tears to evaporate.
        • Always discuss side effects and eye health history with your primary caregiver before starting any medication.
        • Use a humidifier in your home or place of work to reduce air dryness.
        • Use lubricating eye drops to relieve dry eye symptoms.
        • Stay hydrated by drinking plenty of water.
        • Regularly consume foods containing Omega-3s or take an Omega-3 supplement to improve tear quality.
        • Wear protective eyewear such as sunglasses when outdoors in order to block wind and debris from irritating the eye.

        If you have any of the mentioned dry eye symptoms, call Antoine Eye Care Dry Eye Center today and schedule an appointment with Dr. Michael Antoine, O.D.. The optometrist will recommend the most up-to-date dry eye treatments for your eyes and condition.

        REFERENCES

        Request An Appointment
        Call 314-207-7355
        Learn More About Dry Eye
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        Lagophthalmos and Dry Eye

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        Woman with Meibomian Gland Dysfunction

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        Everything You Need to Know About Meibomian Gland Dysfunction

        If your eyes itch, burn, sting, look red, or you have a constant feeling of something being lodged in your eye, you may have a condition called Meibomian (“my-BOH-mee-an”) Gland Dysfunction, or MGD. This condition is the leading cause of Dry Eye Syndrome.

        Patients from throughout the St. Louis area suffering from Meibomian Gland Dysfunction. If you suffer from any of these symptoms or think you might have MGD, contact the Antoine Eye Care Dry Eye Center. Dr. Michael Antoine, O.D. can help you with the long-term relief you need.

        What is Meibomian Gland Dysfunction?

        Our tears are made up of three components: the lipid (oil) layer, aqueous (water) layer, and the mucus (sticky) layer. These components work in unison to lubricate and coat the eyes, keeping them moist and comfortable.

        Your meibomian glands control the lipids in the eye (meibum) which combine with water and mucus in the eye area to create a thin film that consistently lubricates your eyes. Meibum is an essential part of your eye’s makeup as it prevents the evaporation of the eye’s tear film.

        Meibomian Gland Dysfunction occurs when the meibomian glands fail to provide enough meibum. This can be triggered by various factors and causes the tear film to evaporate at a quicker rate, leading the eyes to feel dry and uncomfortable.

        What Are the Symptoms of Meibomian Gland Dysfunction?

        Depending on your specific case, your symptoms may be mild or severe, quick or long-lasting.

        The most common symptoms of MGD include:

        • Blurry vision
        • Burning and dry sensation
        • Difficulty wearing contact lenses
        • Watery eyes
        • Red, sore and gritty eyes
        • Crusty or sticky eyelids

        The increased use of air conditioning or heating systems in the summer and winter months may intensify symptoms. Humid climates, extreme temperatures, and dusty and windy conditions may aggravate eye dryness and itchiness as well.

        What are the Causes of Meibomian Gland Dysfunction?

        • Age: MGD tends to manifest in older people, particularly in women during and after menopause
        • Taking certain medications: particularly retinoic acid (acne treatment), HRT (hormone replacement therapy for menopausal women), antidepressants, antihistamines, anti-androgen medication (used to treat prostatic hypertrophy).
        • Endocrine disorders
        • Pregnancy
        • Wearing contact lenses for an extended period of time.
        • Immune system disorders: atopic rosacea, psoriasis, rheumatoid arthritis and Sjogren’s syndrome.

        Excessive screen time has also been linked to the development of MGD. Staring at a screen on your TV, smartphone, computer or tablet, causes you to blink less frequently. Blinking naturally moisturizes your eyes, and by doing so, clears any small particles that may have accidentally lodged in your eye. Less frequent blinking results in dryer eyes, which can harm the long-term ability of your meibomian glands to function properly.

        What are the Solutions for Meibomian Gland Dysfunction?

        Treatments for Meibomian Gland Dysfunction range from self-administered or practitioner-administered treatments and typically involve a few methods, such as artificial tears, heat application, and manual gland expression. Dr. Michael Antoine, O.D. usually suggests applying warm compresses over your eyelids as a first course of action. This gently opens the clogged glands and loosens the oil that may have accumulated. Warm compresses can provide temporary relief.

        Further therapies used to manage MGD include omega-3 supplementation, topical antibiotics, oral tetracyclines to reduce the level of pro-inflammatory cytokines, corticosteroids, or topical cyclosporine.

        People with MGD commonly purchase over-the-counter eye drops to lubricate their eyes. Unfortunately, these drops tend to provide only transient relief, because, without an adequate layer of Meibomian Gland oil, the liquid from the drops simply evaporate off of the eye. Dr. Michael Antoine, O.D. at Antoine Eye Care Dry Eye Center can recommend the appropriate eye drops or treatment for your dry eye case to improve your eye comfort levels.

        Think You Have MGD? We Can Help

        If you are suffering from any of the above symptoms or conditions, then reach out to the Antoine Eye Care Dry Eye Center. Based on the degree of your condition, symptoms, and lifestyle, Dr. Michael Antoine, O.D. will recommend the best course of treatment for you.

        “I went to the Antoine Eye Care Dry Eye Center and everyone there was professional and courteous. Dr. Michael Antoine, O.D. did a thorough evaluation and treatment. I’m happy to say that my eyes feel comfortable and my vision is back to how it was before the condition began.”

        Jennifer P. Craig, Yen-Heng Chen, Philip R. K. Turnbull; Prospective Trial of Intense Pulsed Light for the Treatment of Meibomian Gland Dysfunction. Invest. Ophthalmol. Vis. Sci. 2015;56(3):1965-1970. doi: 10.1167/iovs.14-15764.

        Request An Appointment
        Call 314-207-7355
        Learn More About Dry Eye
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        Lagophthalmos and Dry Eye

        Why Dry Eye Affects More Women Than Men Thumbnail.jpg

        Why Dry Eye Affects More Women Than Men

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