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Lagophthalmos is the inability to close the eyelids completely. [1]Blinking covers the eye with a thin layer of tear fluid, thereby promoting a moist environment necessary for the cells of the exterior part of the eye.
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Commonly, amaurosis fugax caused by giant cell arteritis may be associated with jaw claudication and headache. However, it is also not uncommon for these patients to have no other symptoms. [18] One comprehensive review found a two to nineteen percent incidence of amaurosis fugax among these patients. [19] Systemic lupus erythematosus [20] [21]
With the eye generally profusely watering, the type of tears being produced have little adhesive property. Water or saline eye drops tend therefore to be ineffective. Rather a 'better quality' of tear is required with higher 'wetting ability' (i.e. greater amount of glycoproteins) and so artificial tears (e.g. viscotears) are applied frequently.
An important risk factor is increased intraocular pressure (pressure within the eye) either through increased production or decreased outflow of aqueous humour. [8] Increased resistance to outflow of aqueous humour may occur due to an abnormal trabecular meshwork or due to obliteration of the meshwork resulting from injury or disease of the iris.
General anaesthesia reduces the tonic contraction of the orbicularis oculi muscle, causing lagophthalmos i.e. the eyelids do not close fully in 59% of patients. [3]In addition, general anaesthesia reduces tear production and tear-film stability, resulting in corneal epithelial drying and reduced lysosomal protection.
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Causes of epiphora are any that cause either overproduction of tears or decreased drainage of tears, resulting in tearing onto the cheek. [2] This can be due to ocular irritation and inflammation (including trichiasis and entropion) or an obstructed tear outflow tract, which is divided according to its anatomical location (i.e., ectropion, punctal, canalicular or nasolacrimal duct obstruction).
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