This syndrome can be caused by a number of factors such as exophthalmos, which is a protrusion of the eyeball, macroblepharon, which is a large eyelid opening and lagophthalmos, which is an inability to completely close the eyelid. These factors result in the cornea to be exposed, an inability to blink properly and the easy evaporation of tears. The syndrome can lead to corneal ulcers, and a pigmentation of the cornea that may cause vision impairments. Symptoms are generally red eyes, increased tears and pawing at the eyes. Treatment for Exposure Keratopathy Syndrome is usually various surgeries but tear substitutes have been used as a temporary treatment.