title: Lagophthalmos in enophthalmic eyes.
abstract: OBJECTIVE
  To report a case series of enophthalmic patients with lagophthalmos.
  
  
  METHODS
  A retrospective review of the electronic medical records at a tertiary health care centre of all patients with the diagnoses of "enophthalmos" and "lagophthalmos". Patients who had a history of diseases (such as Graves' orbitopathy), trauma or surgery of the orbit and eyelid were excluded. Enophthalmos was defined as exophthalmometric reading of 14 mm or less in both eyes.
  
  
  RESULTS
  Seven patients (14 eyes) with bilateral enophthalmos were found to have concomitant lagophthalmos. All patients had deep superior sulci bilaterally. The upper eyelids were seen to be severely retro-placed behind the superior orbital rim. The extraocular motilities were full with no focal neurological deficit. The orbicularis oculi function was normal with no facial paralysis. The orbits were soft on retropulsion and no facial asymmetry was noted. The mean exophthalmolmetry reading measured 12.6 (SD 1.1) mm. The lagophthalmos varied from 1-5 mm. One patient (one eye) with 3 mm lagophthalmos developed a corneal ulcer and was treated with topical antibiotics and gold weight placement in the upper eyelid.
  
  
  CONCLUSIONS
  Enophthalmic patients with deep superior sulci and retro-placed upper eyelids may present with lagophthalmos and exposure keratopathy.
authors.affiliation: Orbital and Ophthalmic Plastic Surgery Division, Jules Stein Eye Institute, UCLA School of Medicine, Los Angeles, CA, USA. chee_chew_yip@ttsh.com.sg
authors.forename: C-C
authors.initials: CC
authors.lastname: Yip
authors.forename: M
authors.initials: M
authors.lastname: Gonzalez-Candial
authors.forename: A
authors.initials: A
authors.lastname: Jain
authors.forename: R A
authors.initials: RA
authors.lastname: Goldberg
authors.forename: J D
authors.initials: JD
authors.lastname: McCann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003320:Corneal Ulcer / Q000209:etiology; D015841:Enophthalmos / Q000150:complications* / Q000473:pathology; D005141:Eyelid Diseases / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010781:Photography; D012189:Retrospective Studies