Exposure keratopathy (EK) is a potentially visually devastating condition that occurs when there is compromise of ocular surface protection. It can occur due to many etiologies, and identification of the underlying cause is critical for guiding management. Long-term treatment will vary based on the underlying cause of exposure and can include medical management of systemic conditions, contact lens, permanent tarsorrhaphy, surgical correction of the eyelid or globe malposition, and corneal neurotization. In the following chapter, the management of several cases of EK due to mechanical, paralytic, and neurogenic causes is reviewed in depth.