Optometry Research Today is a free monthly online journal that collates and summarizes the latest research about Optometry, including details on myopia, optometric practice, therapy.

Supportive care of facial nerve palsy with temporary external eyelid weights.

Zwick OM, Seiff SR

Oculofacial Plastic Surgery, Department of Ophthalmology, San Fransisco General Hospital, University of California San Francisco, San Francisco, California 94110, USA. ozwickmd@yahoo.com

BACKGROUND: Patients with facial nerve palsy can have many ocular complications. Lagophthalmos, or poor eyelid closure, and loss of blink secondary to lack of nerve supply to the orbicularis oculi, can lead to exposure keratopathy, corneal breakdown, ulcers, and even perforation. Management of patients should be directed toward the severity of ocular findings and ranges from supportive care to surgical reanimation and soft tissue repositioning. Patients with facial nerve palsy who present at earlier stages can benefit from conservative treatment. Use of temporary external eyelid weights can help restore a functional blink mechanism and prevent corneal decompensation. CASE REPORT: A 29-year-old patient with lagophthalmos secondary to left facial nerve palsy after surgical excision of an acoustic neuroma was treated with a temporary external eyelid weight. CONCLUSION: Temporary external eyelid weights are part of the armamentarium in the supportive care of patients with lagophthalmos and exposure keratopathy secondary to facial nerve palsy. They are most useful in patients who have temporary paralysis or as a bridge until further surgery can be performed.

Published 3 July 2006 in Optometry, 77(7): 340-2.
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