Proper closure of the eyelids is important in maintaining the lubricated corneal surface of our eyes. It is also essential in maintaining the stable clear film of the cornea. The blinking reflex that we have is not only there for preventing foreign objects from getting to our eyes, but this also helps in retaining the moisture that we have in our eyes.
Though some may consider sleeping with eyes open to be impossible – well, it is not. The cases are unusual and rare, but not impossible. People sleeping with their eyes open usually have the condition called “lagophthalmos”. In people with conditions like this, only one eye usually remains open during sleeping.
Reasons Why There Are People Sleeping With Their Eyes Open
People sleeping with their eyes open can result in corneal irritation due to lagophthalmos
Use of hypnotic drugs
Scarring of the eyelids
Damage of the facial nerves responsible for controlling the eyelids
Metabolic disorders such as hyperthyroidism
People sleeping with their eyes open suffer consequences of having dry and irritated eyes. Because of the frequent corneal exposure, corneal ulceration and infectious keratitis may occur.
Sleeping with Open Eyes Evaluation
The health history of a person can help a lot in finding out the cause of the present health condition. A health care provider should ask about any recent accident which involves trauma to the head or any surgery that involves the head and the face. The past infections should also be documented, focusing on the presence of history of herpes zoster infection. Symptoms of metabolic disorders and obstructive sleep apnea should be evaluated.
Testing the lids and globe
The patient is asked to look down and gently close both eyes. In this way, the severity of the lagophthalmos can be evaluated. The blink rate and the ability to blink completely is also observed.
Testing the cornea
The corneal reflex is tested by touching the cornea with a wisp of cotton. If the corneal reflex is present, the person will automatically close the eyes upon feeling the wisp of cotton.
Treatments and Management
Before any treatment is done, the first thing to consider is maintaining the moisture of the cornea to prevent corneal ulceration. In order to do this, administration of artificial tears is needed at least 4 times a day.
The treatments for lagophthalmos are:
Gold weight implantation
Upper eyelid retraction and levator recession
Lower eyelid tightening and elevation
Ancillary surgical procedures
If a person has this kind of condition, immediate medical attention is needed. This is to avoid the worse consequences that may happen.