Eyelid weight

Case contributed by Dr Daniel J Bell

Presentation

Foreign body screening for MRI

Patient Data

Age: 55 years
Gender: Male
X-ray

A curvilinear metallic radiopacity is projected within the superior orbit on the lateral skull radiograph. On the look up and look down projections, the foreign body moves up and down, consistent with its eyelid location. 

Case Discussion

Eyelid weights are employed for patients with paralytic lagophthalmos. This is usually seen secondary to facial nerve (VII) palsy.

A small metallic implant is surgically inserted into the upper eyelid. The implant is usually manufactured from extremely pure gold (99.99% purity). Gold is the ideal substance due to its biological inertness, its density, and the invisibility of the implant when the patient's eyes are closed.

The weights range from 0.6 to 1.6 grammes, and are available in 0.2 g increments. A manufacturer-supplied eyelid weight testing kit is used to find the optimal weight implant.

In patients that have a history of allergy to gold (up to 10% of patients) a platinum weight is used as an alternative.

The procedure is reversible if the lagophthalmos resolves.

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Case information

rID: 59821
Published: 26th Apr 2018
Last edited: 14th Aug 2019
System: Head & Neck
Inclusion in quiz mode: Included
Institution: North Middlesex University Hospital

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