Management of Long-Standing Flaccid Facial Palsy: Periocular Considerations

Abstract

Ineffective eyelid closure can pose a serious risk of injury to the ocular surface and eye. In cases of eyelid paresis, systematic examination of the eye and ocular adnexa will direct appropriate interventions. Specifically, 4 distinct periorbital regions should be independently assessed: eyebrow, upper eyelid, ocular surface, and lower eyelid. Corneal exposure can lead to dehydration, thinning, scarring, infection, perforation, and blindness. Long-term sequelae following facial nerve palsy may also include epiphora, gustatory lacrimation, and synkinesis.

Keywords: Dry eye; Ectropion; Epiphora; Exposure keratopathy; Eyelid retraction; Lagophthalmos; Synkinesis.