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    Diagnosing and treating lagophthalmos

    Korb Blackie light test can help identify the severity of incomplete lid closure

    Since I read Dr. Robert Latkany’s study on nocturnal lagophthalmos in 2006,1 I am perpetually on the lookout for it, especially in the patients who present with dry eye symptoms. Sometimes it’s easy to spot lagophthalmos—sometimes, if you ask your patient about lid closure, they will report to you that they know about their incomplete lid closure, mostly when they sleep. One of my favorite stories is about the young woman who said, “Yeah, my boyfriend always asks me why my eyes aren’t closed all the way when we kiss!”

    More from Dr. Mastrota: How hygiene products affect ocular surface and lids

    Korb-Blackie lid-light evaluation

    My method of checking for lagophthalmos is to instill fluorescein as usual, then look at the patient’s closed lids under cobalt blue light at the slit lamp from below. Any green glow visible is suggestive of incomplete lid contact. There is another way, however. At the end of last year, Blackie and Korb published a paper that describes the Korb-Blackie light test—a method to establish if the lids are truly in contact with each other during normal eye closure.2

    Briefly, the Korb-Blackie lid-light evaluation is performed by placing a transilluminator against the relaxed, closed, outer upper eyelids of semi-reclined patients. The amount of visible light emanating from the lid area between the lashes is quantified in which zero represents no light; one represents minimal light; two represents moderate light; and three represents severe light around the temporal, central, and nasal sections of the eyelids. Light emanating from between "closed" lids during the Korb-Blackie lid-light evaluation

    Next: Lagophthalmos examination

    Katherine M. Mastrota, MS, OD, FAAO, Dipl ABO
    Director of Optometry, New York Hotel Trades Council, Hotel Association of New York City, Health Center, Inc.


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