Getting Closure on Incomplete Blink

Getting Closure on Incomplete Blink

by Brian Chou, OD, FAAO, FSLS

  • August 12, 2023

Did you know that some people cannot fully close their eyes? This condition is called lagophthalmos. While you might believe that this is a biological curiosity – just like yawns and hiccups – lagophthalmos can cause miserable pain due to the sensitive eye surface drying out.

Causes of Lagophthalmos

Incomplete eyelid closure has several possible causes, including:

  • A side effect of a cosmetic eyelid surgery called blepharoplasty.
  • Paralysis of the Facial Nerve (Cranial Nerve VII), due to infection or trauma.
  • Thyroid eye disease, where swollen eye muscles can cause the eyes to bulge out.
  • Tumors, which cause the eyes to bulge out or cause facial nerve paralysis.

Most with undiagnosed lagophthalmos do not realize that they have an incomplete blink unless someone points it out. Similarly, someone that snores and grinds their teeth often won’t know that they do this unless they are told.

With examination, an eye doctor can formally diagnose you with lagophthalmos.

Treatment of Lagophthalmos

Common treatments include eye lubricants, including gels and ointments, to prevent the eye surface from drying. Adhesive bandage tape can forcefully keep the eyelids closed. There are also “moisture chamber” goggles that keep the eyes moist. Finally, there are various eyelid surgeries to reduce the exposure surface area, and even implantation of weights into the eyelids to help them close.

Scleral Lenses for Lagophthalmos

A newer treatment for daytime lagophthalmos are scleral contact lenses. Scleral contact lenses trap non-preserved saline against the eye, maintaining hydration of the eye tissue even if the eyelids don’t fully close. While scleral lenses are commonly prescribed to restore vision for eye diseases like including keratoconus, scleral lenses can provide relief for patients with incomplete blink.

Unlike the legacy treatments for lagophthalmos, scleral lenses do not require continual reapplication of lubricant drops to the eye. Unlike ointment in the eye which can disturb vision, scleral lenses generally improve vision by improving the focus of light into the eye. Finally, scleral lenses avoid risks associated with surgery.


ReVision Optometry is a referral-based practice in San Diego providing scleral contact lens services for patients with keratoconus and other complex eye conditions. To schedule an appointment, request your examination online or call our office at 619.299.6064.