Greetings to all and sundry,
How are we all doing? Since I wasn't able to be here with you all yesterday which was the official independence day for Ghana, I want to use this opportunity to say Happy Independence day to all my fellow Ghanaians on the blockchain, may our days be bright as patriotic citizens. Yesterday, was an interesting and quite exhausting day for me.
I wish so much to share this interesting diagnosis I made with you, however, the workload and the stress from yesterday saw me sleep throughout the rest of the evening after work and I only gained consciousness this morning, I was almost late for work. I still feel pretty much exhausted though however, I feel better than yesterday so, let's use the opportunity to learn.
I'd love to hear about your week, how it started, and if you did anything interesting on social media or with the family regarding Ghana's independence day parade. Anyway so let's look at what we are learning today and then we can have more time together in the comment section.
A lot happens when we sleep, our system goes into some form of hibernation mode and the time of active duty is used to repair worn-out tissues and ready up the soldiers of our body's civilization for another battle the day to come. Sleep is essential to our daily lives and even more, quality sleep, but one may ask how we sleep?
I have seen people fall asleep sitting beside loudspeakers and didn't even feel a thing, then some couldn't sleep because there was some mild music going on in their backyard, and some could even sleep although the was that serenity. Then there are those special individuals that literally sleep with their eyes open, they can be looking at you and still be gone.
Those are one interesting group of people though, for today our topic falls under this category of people, those with our topic for discussion today sleep but could easily be mistaken for not being completely asleep, or perhaps trying to rest with their eyes closed or something, it is interesting when you come across these individuals and even more interesting when you make a diagnosis and try to find a solution to it.
This situation as interesting as it sounds, doesn't really do much of any good to the sufferer and things can get pretty bad for the person. If you have noticed it with any of your friends, colleagues, or neighbors it would be advisable to draw their attention to it and encourage them to consult with their Optometrist or Ophthalmologist. So we are looking at lagophthalmos today.
This is a condition that comes with paresis or palsy of the 7th cranial nerve also known as the facial nerve. What happens is that the individual diagnosed with the condition or having the condition finds it difficult closing their eye voluntarily. The facial nerve supplies the orbicularis oculi muscle which surrounds the eye and is in the lids of the eye. Its innervation brings about the lid closure.
It may also happen in situations where the lower lid is turned outward from the eye, a condition known as ectropion. This doesn't allow the lids to meet up together when one tries to close the eyes and so the eye gets exposed although one may have closed the eye. It may also occur when there is scarring of the lid's skin, affecting their closure together. In the case of symblepharon (a situation where the lids get attached to the eyeball), the closing of the eye may also get affected.
There are also cases of the eyeball popping out or should I say protruding, I think thus a better word, this may be seen in the case of thyroid eye disease where the eyeball bulges out and is quite conspicuous to the one who knows what they are looking for or what they are seeing. When this happens the eyelids may not be able to meet entirely as they ought to when one closes the eye leaving some room for exposure to the atmosphere.
Lagophthalmos can be very worrying because our sleep tear production is reduced, so the exposed part that dries up could end up being damaged in one way or another. That part of the eye could easily get infected with microbes in the atmosphere, it could easily become ulcerative, it could easily scar or perforate if there's damage to that part and it could have negative repercussions on the person's vision and ocular health generally.
It thus becomes important that this situation is handled once diagnosed or noticed. It may not necessarily take a clinician to see this, one can easily tell just by looking at a sleeping friend's eye, if the eyes are not fully closed you can tell, it may look as though he is trying to close the eye when the person is already asleep. As for facial nerve palsy, it is quite obvious because the person won't be able to close the eye and wouldn't definitely see the primary eye care physician who may refer him to a neurologist for a look at the underlying cause.
If you wake up feeling lots of dryness in your eye, perfects pain, and a burning sensation every morning, well it is a differential to be considered, visit your Optometrist today, and once again I would say be your brother's keeper, if you notice their eyes not completely close when they sleep, draw their attention so it may be looked at for them before they end up with damages to their eye or sight.
It is better safe than sorry, and it is better late than never, if you have yet to have your eyes checked I would advise that you have a comprehensive eye examination today, you may have just saved your sight by doing so, and you would be amazed the number of patients losing their sight to preventable eye conditions.
When in doubt always consult a professional, and avoid the use of over-the-counter medication without proper exams or prescription from your primary care physician. Love your sight, protect your eyes, stay safe, and have a wonderful week I wish you the very best, thanks for reading and for your time.
Latkany, R. L., Lock, B., & Speaker, M. (2006). Nocturnal lagophthalmos: an overview and classification. The ocular surface, 4(1), 44–53. https://doi.org/10.1016/s1542-0124(12)70263-x.
Vásquez, L. M., & Medel, R. (2014). Lagophthalmos after facial palsy: current therapeutic options. Ophthalmic Research, 52(4), 165–169. https://doi.org/10.1159/000365519.
Rita, M. R. H., Deepa, M., Gitanjali, V. C., Tinu, S. R., Subbulakshmi, B., Sujitha, D., Palthya, G., Saradha, M., Vedhavalli, T., Sowmiya, B., Akalya, R., Mathivadhani, L. S., Uma, M., Bhavani, R., & Violet, J. R. (2022). Lagophthalmos: An etiological lookout to frame the decision for management. Indian journal of ophthalmology, 70(8), 3077–3082. https://doi.org/10.4103/ijo.IJO_3017_21.
Fu, L., & Patel, B. C. (2022). Lagophthalmos. In StatPearls. StatPearls Publishing..
Lagophthalmos from what you said is a problem but what I didn't get from the post was how does it come about? Is it genetically caused? And how do they treat it. Thank you
I mentioned some few of the causes, like palsy of the facial nerve, proptosis or bulging of the eye due to thyroid eye disease etc, also treatment requires the use of ocular Lubrication to keep the eye moist and treating the underlying cause, in some cases such as ectropion, surgery may be required
Okay, thank you.
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I have seen people with this condition, unfortunately, I didn't realize then it was due to some conditions.
Really learnt something new here.
Ps: I really don't know the intention of this person that goes around downvoting deserving articles. Why do others have to pay the price for something really not worth it.
Either way, don't relent.
I’m glad you got a thing or two from what I had to share, thank you so much for your time and for passing through.
And thank you so much for the words of encouragement, they surely can’t let me give up on writing because of a downvote, I’d continue to give my best always and it’s such a pleasure to see you around😊