METHOD OF SELECTING MANAGEMENT AND CONSERVATIVE TREATMENT OF PATIENTS WITH PARALYTIC LAGOPHTHALMOUS Russian patent published in 2023 - IPC A61H5/00 A61F9/07 A61K31/197 A61P27/04 

FIELD: medicine, neurology, ophthalmology, rehabilitation, surgery.

SUBSTANCE: width of the palpebral fissure is measured with the eyelids close, and the following is determined: the position of the upper eyelid, the position of the lower eyelid, the condition of the cornea and conjunctiva. The degree of lagophthalmos is determined. When a mild degree of lagophthalmos is detected, preventive measures are prescribed in the form of instillations of an artificial tear and the laying of dexpanthenol. If the II moderate degree of lagophthalmos is detected, in addition to the prescribed treatment, a complex of physiotherapy exercises (exercise therapy) is prescribed with an effect on the levator of the upper eyelid and the circular muscle of the eye, aimed at stretching the muscles of the levator of the upper eyelid and restoring the balance between the mentioned muscles. If the III degree of lagophthalmos is detected, in addition to the prescribed treatment for degrees I and II of lagophthalmos, the position of the eyelids is corrected using a patch applied to the upper and lower eyelids during the day, mainly in a horizontal position, ensuring narrowing of the palpebral fissure, and at night - mainly in the vertical position of the patch to ensure the closure of the upper and lower eyelids. When IV severe lagophthalmos is detected, treatment is recommended for grades I–II of lagophthalmos with surgical correction of the position of the eyelids by suturing the ectropion with shortening of the lower eyelid and performing exercise therapy 2 weeks after surgical correction. When identifying V complicated degree of lagophthalmos, tarsorrhaphy is performed.

EFFECT: method allows to increase the efficiency of treatment of patients with paralytic lagophthalmos due to the use of an exercise therapy complex, which makes it possible to restore the balance between the orbicular muscle of the eye and the levator of the upper eyelid.

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