Kaufman, and fellow researcher Jeffrey Katz, M.D., described nocturnal lagophthalmos as “corneal exposure during sleep a relatively common cause of previously undiagnosed, chronic keratitis.” 1 One of the first individuals to discuss nocturnal lagophthalmos in the modern era was Herbert Kaufman, M.D. If the answer to these questions is “yes”––as was the case in our patient––then the likely diagnosis is nocturnal lagophthalmos. Has anyone ever mentioned that you sleep with your eyes partially open?.Do you sleep under an air vent or ceiling fan?.Are your symptoms worse upon awakening, and do they tend to improve throughout the day?.
In the case presented above, a few simple questions helped lead us to the appropriate cause:
But, in all cases of ocular surface disease, it is important to inspect for mechanical and anatomical dysfunctions that can be at the root of the problem. In some instances, we may sense a bacterial or allergic component, and will then add an antibiotic, antihistamine or anti-inflammatory agent (or a combination of these) to the mix. Most eye care providers tend to lump these individuals into the broad diagnostic category of “dry eye,” and treat reactively with one or more artificial tear solutions. Many patients present with ocular burning and irritation as either a chief or peripheral complaint. What can we do to help provide this patient with some relief? I’ve tried all types of eye drops, but most of them sting and nothing provides the relief I need.” I get a little relief after I shower, but my eyes are still very red and irritated for most of the day. “Some days, they burn so badly I can barely open them. “My eyes feel like sandpaper in the morning,” she claimed. A 46-year-old woman was referred for a specialty ocular surface evaluation after being seen by her family optometrist.
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