The management of the ocular sequelae of facial palsy should be individualized for
each patient. The patient's age, ocular motility, tear production, and corneal sensation
are considered when developing a treatment plan. Individuals with transient weakness
often require only therapy with topical lubricants. Permanent or chronic facial paralysis
is usually associated with lagophthalmos, ectropion, and exposure keratitis. Both
“static” and “dynamic” procedures can be performed to improve these conditions. Combined
eyelid surgery and suspension of the midface often provides the best result. However,
patients with permanent facial palsy usually suffer chronic ocular symptoms, requiring
long-term follow-up and continued topical therapy.
KEYWORDS
Lagophthalmos - paralytic ectropion - exposure keratopathy
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Philip L CusterM.D.
Department of Ophthalmology, Washington University School of Medicine
660 S. Euclid Avenue, Box 8096
St. Louis, MO 63110