A 48 year old Kentucky man was admitted to the ICU for hepatic failure secondary to portal thrombosis of unknown etiology, bilateral facial weakness and an inability to close his eyes. On admittance his pupils were equal and reactive to light acuity (PERLA) with benign optic fundi. After eight days in the ICU the patient was noted to have very red eyes. He was given ocular lubricants, including drops and ointment, and his eyes were taped shut during sleep hours. After discharge the patient's ocular condition was followed at a major medical center where he underwent bilateral tarsorrhapies three months later. He remains legally blind pending cornea transplant surgery. A medQuest ophthalmologist opined there was an immediate failure to provide adequate ocular protection for a patient with lagophthalmus or the inability to close the eyes for whatever reason. Furthermore, when the ocular exposure was discovered there was a lack of intensive preventive and therapeutic measures such as topical antibiotics. An ophthalmologist was never called. With appropriate care the patient's blindness should have been avoided.