Tarsorrhaphy: Why Doctors Close the Eyelids, Types, Methods and Recovery
Updated: 6 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026 · How we review
Quick Answer: What is tarsorrhaphy?
Tarsorrhaphy is a procedure that keeps one or both eyelids partly or fully closed so a damaged or exposed eye surface can heal. It treats problems such as incomplete eyelid closure, exposure keratitis, corneal burns and nerve-damaged corneas. Methods include tape, glue, stitches, botulinum toxin or surgery, and most forms are reversible. [1]
What the research says
Tape closure healed most stubborn corneal wounds. In 34 eyes with a corneal surface defect lasting 14 days or longer, tape splint tarsorrhaphy healed 29 eyes (85.3%) without extra treatment, in about 22.5 days on average, and vision improved significantly. No complications were linked to the tape. (Mimouni et al., American Journal of Ophthalmology, 2022) [2]
Temporary stitches helped protect eyes with severe fungal ulcers. Among 119 patients with fungal corneal ulcers close to perforating, temporary suture tarsorrhaphy reached an anatomical success rate of 87.39%, and 52.1% of patients gained two or more lines of vision. (Maharjan et al., Nepalese Journal of Ophthalmology, 2022) [3]
Tape tarsorrhaphy managed incomplete eye closure after eyelid surgery. In 112 patients treated for severe congenital droopy eyelid, tape closure was used to manage lagophthalmos afterward; all patients or guardians were satisfied with the cosmetic result, and the authors rated it safe and easy to learn. (Sun et al., Annals of Plastic Surgery, 2024) [4]
Key takeaways
Tarsorrhaphy holds the eyelids closed the way a cast holds a broken bone still while it heals. [1]
It can be partial (you still see through a gap) or total (the lids are sealed shut). [1]
Closure can last days, weeks, months or years, and most methods can be reversed. [1]
Reported success rates for healing eye surface problems range from 80% to 100%. [1]
Don't rub the eye, keep follow-up visits, and call your provider about loose stitches, vision changes or signs of infection. [1]
What is tarsorrhaphy and how does it work?
Tarsorrhaphy is a medical procedure that keeps the eyelids shut for longer periods to protect the surface of the eye. [1]
Think of it like a cast. A cast holds a broken arm still while the bone heals. Tarsorrhaphy holds the eyelids in place so the front of the eye stays covered, moist and shielded from further injury. [1]
It is usually done on one eye only (unilateral), but both eyes can be treated when needed. [1]
The word is pronounced "tar-SORE-oh-fee." It comes from two Ancient Greek words meaning "foot" and "to sew." The "foot" is the lower edge of the eyelid, where the upper and lower lids meet and seal. [1]
Despite the name, stitches are only one option. Several methods close the eye without any sewing at all. [1]
Why is tarsorrhaphy done?
Tarsorrhaphy is done to protect an eye surface that is already damaged or at high risk of damage, usually because the eyelids cannot close properly on their own. [1]
Sometimes it treats a problem that has already happened. Other times it prevents complications before they start. [1]
Eye surface diseases and injuries
Condition | Why closing the eye helps |
Incomplete eyelid closure (for example, Bell's palsy) | The lids can't cover and protect the eye surface [1] |
Long-term sedation on a breathing machine | People who can't close their eyes fully have a much higher risk of corneal damage [1] |
Exposure keratitis | Inflammation and damage from too much exposure to air or harsh temperatures [1] |
Corneal burns | Includes heat (thermal) burns and chemical burns (corneal flash burns explained) [1] |
Includes corneal dystrophies, injuries, infections and their treatments [1] | |
Neurotrophic keratitis | The cornea loses feeling, so it can't sense irritants or foreign objects [1] |
Recurrent corneal erosions and other keratitis | Used when they don't heal properly or quickly [1] |
Chemosis (swelling of the eye's white) | Helps prevent swelling after an eye injury or eye surgery [1] |
Conditions that change the shape or position of the eye
When the eyeball shape or position changes, the eyelids may no longer close over it. Not being able to close one or both eyes is called lagophthalmos (read more on lagophthalmos). [1]
Causes include:
Bulging eyes (proptosis) [1]
Eye cancers and tumors in or around the eye [1]
Graves' disease and thyroid eye disease (learn about Graves' disease) [1]
Severe conditions or injuries that lead to partial eye removal (evisceration) or total eye removal (enucleation) [1]
Eyelid conditions, injuries or surgery
Problems with eyelid movement, position or control can also stop the eyes from closing well:
Floppy eyelid syndrome [1]
Facial paralysis, including Bell's palsy, Moebius syndrome or facial nerve damage (see how the facial muscles and their nerve work) [1]
Ectropion, where the eyelid turns outward and can't seal shut [1]
Conditions that reduce consciousness or blinking, such as a coma after a severe head injury [1]
What are the different types of tarsorrhaphy?
Tarsorrhaphy types differ in three ways: how long the closure lasts, how much of the eye is closed, and the method used to close it. [1]
How long does tarsorrhaphy last?
Partial vs total tarsorrhaphy
What methods are used to close the eye?
Method | How it works | Notes |
Tape splints | Adhesive strips hold the eye shut | No stitches; tape can irritate skin [1] |
Cyanoacrylate glue | Medical-grade glue bonds the lid edges | Can irritate skin [1] |
Temporary sutures | Stitches the body absorbs | Dissolve on their own [1] |
Permanent sutures | Stitches that don't dissolve | A provider removes them later [1] |
Botulinum toxin (OnabotulinumtoxinA) | Temporarily paralyzes the muscles that open the eye | No stitches; effect is temporary [1] |
Surgery | Uses sutures alone, or skin taken from elsewhere, to close the eyelid opening permanently | Permanent closure [1] |
Your eye care specialist chooses the type and method based on how long the eye needs to stay closed and how much protection it needs. [1] For a clinician-level overview of techniques, see the ophthalmology reference on tarsorrhaphy.
What are the benefits and risks of tarsorrhaphy?
Tarsorrhaphy is highly effective, with reported healing success rates of 80% to 100%, but it limits vision while the eye is closed. [1]
Advantages | Disadvantages |
Many different ways to do it [1] | No driving until your ophthalmologist says it's OK [1] |
Very high success rate for healing eye problems (80% to 100%) [1] | Tape and glue can irritate the skin [1] |
Can prevent more serious or permanent damage [1] | Reduced vision in part of your field of view while the eye is shut [1] |
Can last months or even years [1] | Surgical methods carry usual surgery risks: pain, bleeding and infection [1] |
Most methods are reversible [1] |
How much your vision is affected depends on whether the closure is partial or total, and on the method used. [1]
Does tarsorrhaphy hurt, and how soon will I feel better?
Tarsorrhaphy with stitches or surgery is done after your provider numbs the skin with topical medicine, so the procedure itself shouldn't hurt. [1]
Afterward, your specialist may prescribe pain medicine. Many people need nothing at all, or only over-the-counter options such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs). [1]
For temporary closures, the time the eye stays closed varies. Follow-up visits let your specialist check healing and decide if and when to reverse the tarsorrhaphy so you can use the eye again. [1]
How do I take care of my eye after tarsorrhaphy?
Good aftercare after tarsorrhaphy comes down to three habits: don't rub the eye, follow your specialist's instructions exactly, and attend every follow-up visit. [1]
Don't rub your eyes. Rubbing can disrupt healing and be very painful. Ask your specialist how to handle any itching on or around the eyelid. [1]
Follow instructions exactly. After stitched tarsorrhaphy, it's common to wear an eye shield or other protective cover so nothing touches the eye or eyelid. [1]
Keep follow-up visits. These checks are a key part of getting the full benefit of the procedure. [1]
If you live with dry, irritated eyes alongside your condition, our guide to dry eye symptoms and relief may help you understand your symptoms.
When should I call my doctor after tarsorrhaphy?
Call your healthcare provider after tarsorrhaphy if stitches loosen, your vision changes, or the closed eyelid shows signs of infection. [1]
Contact your provider if you notice:
Conclusion
Tarsorrhaphy may sound alarming, but it is one of the most reliable ways to protect an eye that can't protect itself. By holding the eyelids partly or fully closed, it gives the cornea time to heal after burns, infections, nerve damage or conditions like Bell's palsy and thyroid eye disease. Closure can be as simple as tape or as lasting as surgery, and most forms can be reversed once the eye recovers.
If your eye care specialist has suggested tarsorrhaphy, ask which type and method they recommend, how long the eye will stay closed, and how often you'll need follow-up checks.
Want to understand the condition behind your treatment? Explore our guides on keratitis, Bell's palsy and corneal disease, and share this article with anyone preparing for eyelid closure.
FAQ
What is tarsorrhaphy used for?
Tarsorrhaphy is used to protect and heal the surface of the eye when the eyelids can't close properly. It helps with conditions such as Bell's palsy, exposure keratitis, corneal burns, neurotrophic keratitis, bulging eyes and thyroid eye disease. [1]
Is tarsorrhaphy permanent?
Tarsorrhaphy is usually temporary, lasting days to weeks, although long-term temporary closures can last months or years. Permanent tarsorrhaphy is reserved for cases that need lifelong closure and can't easily be reversed. [1]
Can you see after a tarsorrhaphy?
You can still see through a partial tarsorrhaphy, because a gap stays open in the middle of the eyelids. A total tarsorrhaphy seals the eye shut, so vision in that eye is blocked until it's reversed. [1]
Is tarsorrhaphy reversible?
Most tarsorrhaphy methods are reversible. Your eye specialist uses follow-up visits to decide if and when to reopen the eye. [1]
Does tarsorrhaphy require stitches?
Tarsorrhaphy does not always require stitches. Tape splints, medical-grade glue and botulinum toxin can all close the eye without sewing. [1]
How successful is tarsorrhaphy?
Tarsorrhaphy has a very high success rate for healing eye surface problems, reported at 80% to 100%. [1]
Can I drive after tarsorrhaphy?
You shouldn't drive after tarsorrhaphy until your ophthalmologist says it's safe. Closing part or all of one eye reduces your field of view. [1]
When should I see a doctor after tarsorrhaphy?
See your doctor after tarsorrhaphy if stitches loosen or tear, your vision changes, or you notice swelling, redness, discharge or pain around the eyelid. [1]
Does tarsorrhaphy hurt?
The procedure itself should not hurt, because the skin is numbed before stitches or surgery. Afterward, many people need no pain medicine or only over-the-counter options such as acetaminophen.
How do I care for my eye after tarsorrhaphy?
Do not rub the eye, follow your eye specialist's instructions exactly and keep every follow-up visit. After a stitched tarsorrhaphy, you may need to wear an eye shield to protect the area.
Related Reading
Understanding Lagophthalmos: Causes, Symptoms, and Management explains why some eyelids cannot close fully and how it is treated.
Keratitis: Symptoms, Causes & Treatment Guide covers the causes, symptoms and treatment of an inflamed cornea.
Bell's Palsy: Symptoms, Causes, and Treatment explains sudden facial weakness that can stop the eyelid from closing.
Corneal Disease: Symptoms, Causes, Diagnosis, Treatment and Prevention — What You Need to Know outlines common corneal diseases and how doctors diagnose and treat them.
References
Cleveland Clinic. Tarsorrhaphy: Definition, Procedure, Benefits & Recovery. Cleveland Clinic. Last updated December 23, 2024. https://my.clevelandclinic.org/health/treatments/tarsorrhaphy
Mimouni M, Liu ES, Din N, et al. Tape Splint Tarsorrhaphy for Persistent Corneal Epithelial Defects. Am J Ophthalmol. 2022;237:235-240. PMID 34942108. https://doi.org/10.1016/j.ajo.2021.12.006
Maharjan SS, Pant AR, Joshi P, et al. Outcomes of Fungal Corneal Ulcer with Impending Perforation after Temporary Suture Tarsorrhaphy. Nepal J Ophthalmol. 2022;14(27):72-81. PMID 35996906. https://doi.org/10.3126/nepjoph.v14i1.37965
Sun LM, Hao DY, Cao J, et al. Tape Tarsorrhaphy in the Management of Lagophthalmos Caused by Severe Congenital Blepharoptosis Procedures. Ann Plast Surg. 2024;92(1):12-16. PMID 38117043. https://doi.org/10.1097/SAP.0000000000003719
Fowler BT, Panovec C, Mukit FA, et al. Tarsorrhaphy. EyeWiki (American Academy of Ophthalmology). Last updated November 2, 2026. https://eyewiki.aao.org/Tarsorrhaphy
Fu L, Patel BC. Lagophthalmos. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Last updated July 24, 2023. https://www.ncbi.nlm.nih.gov/books/NBK560661/
Medical disclaimer
This article is for general education only and does not replace advice from your doctor or eye care specialist. If you have eye pain, vision changes or an eye injury, seek medical care promptly.
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