Is keeping your eyes closed a treatment? Let's talk about Tarsorrhaphy!

Imagine if you had a broken arm or leg, and you put a cast on it to protect it until it healed. Similarly, when our eyes are injured, infected, or otherwise ill, a special treatment is to temporarily close the eyelids together to give them rest and protection until they heal. In medicine, we call this Tarsorrhaphy . This is usually done on one eye, but it can be done on both eyes if necessary.

Why do you really keep your eyes closed like this? (Tarsorrhaphy)

Simply put, the main goal of this treatment is to prevent further damage to the eye and create a safe environment for the surface of the eye to heal. If the eye is just open, it can be exposed to things like dust and air, which can delay healing. Also, in some medical conditions, we are unable to close our eyes properly. This treatment is very important in times like these.

Are there different types of tarsorrhaphy treatment?

Yes, there are several ways to do this treatment. Your doctor will choose the method that is most suitable for you based on several factors. Let's see what they are.

1. Depending on the duration of treatment required

This can be divided into three main parts depending on the amount of time you need to keep your eyes closed:

• Short-term temporary: This is something that is done for a few days or weeks.
• Long-term temporary: This can be kept for months, maybe even years. But it can be reopened if needed.
• Permanent: This is usually irreversible and is only done in very special cases where the eye needs to be closed for the rest of your life.

2. Depending on the amount of eye contact

• Partial tarsorrhaphy: In this, the eye is not completely closed. Only the two sides of the eyelids are connected together. This leaves a small space in the middle, allowing you to see somewhat through it.
• Total tarsorrhaphy: In this, the two eyelids are completely joined together and closed.

3. Depending on the method used to close the eyes

Various methods are used to keep the eyes closed.

• Tape splints: You can use special adhesive strips to keep your eye closed. This is a very simple method.
• Cyanoacrylate glues: Although they look like household superglue, they are special, safe glues used in medicine.
• Sutures:
• Temporary stitches: These stitches dissolve into the body after a while. They don't need to be cut out and removed again.
• Permanent stitches: These do not dissolve. The doctor will cut and remove these stitches when the treatment period is over.
• Botox®: Yes, you've heard of the ``(OnabotulinumtoxinA)`` injection. When it's injected into the muscle that helps open the eye, it temporarily paralyzes it, causing the eye to close.
• Through surgery: In some cases, especially when the eye needs to be closed permanently, surgery is required to join the two eyelids together using stitches or skin grafts from another area.

What types of conditions does this treatment treat?

There are many situations in which tarsorrhaphy treatment is necessary. Sometimes it is done as a treatment for an existing problem, and other times it is done to prevent future damage.

What are the advantages and disadvantages of this treatment?

Advantages

• Having different methods: You can choose a method that suits your situation.
• High success rate: The success rate of this method in healing eye wounds is as high as 80% - 100%.
• Preventing damage: You can protect your eyes before serious or permanent damage occurs.
• Reversibility: Most methods are temporary, meaning that you can open your eyes again after the required time has passed.

Disadvantages

• Inability to drive: You cannot drive until your doctor gives you permission.
• Vision changes: Your field of view is limited because your eye is closed. If you close your eye completely, you won't be able to see with that eye.
• Skin allergies: Tape or gum can cause skin allergies in some people.
• Surgical Risks: If it is a procedure that involves stitches or surgery, there are common risks associated with any surgical procedure, such as pain, bleeding, and infection.

What to expect after treatment?

During this treatment, your doctor will numb the skin around your eyes and eyelids, so you won't feel any pain. If you experience any discomfort or pain after the treatment, your doctor will prescribe painkillers. You may need to take a simple painkiller like paracetamol (acetaminophen).

Things you should do and when you should see a doctor immediately

To get the most out of your treatment, you need to take care of these things.

• Don't rub your eyes: Don't touch, squeeze, or rub your eyes for any reason. Doing so can damage the stitches and skin, and delay healing. If you experience itching, ask your doctor what to do about it.
• Follow the instructions: Follow the doctor's instructions exactly. Use the eye medication and eye shield exactly as prescribed.
• Go to the clinic on time: Follow-up visits are a very important part of this treatment. Don't skip them.

Call the doctor immediately!

If you experience any of the following symptoms, notify your doctor immediately.

• If the stitches are loosening or feel like they are breaking.
• If there is any change in your vision.
• If you develop new symptoms (pain, swelling, redness) in the skin around your eyes or eyelids.
• If a pus-like fluid is draining from the eye being treated.

No one likes to have their eyes closed. It's normal to feel scared and frustrated about it. But remember, Tarsorrhaphy is a very effective treatment that can prevent serious damage to the eyes. Your eye doctor will explain to you whether this is necessary for your condition and which method is best.

Tarsorrhaphy, eye closure, eye diseases, eye surgery, corneal ulcer, Bell's palsy, proptosis, exposure keratitis