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Management of the Eye in the Setting of Facial Nerve Paralysis

  • Richard C. Allen
Chapter

Abstract

Due to incomplete eyelid closure, the eye is acutely at risk in a patient with facial paralysis. Involvement of an ophthalmologist is necessary to appropriately examine the patient, safeguard the eye, and plan subsequent periocular rehabilitation. Early treatment involves lubrication and possibly the placement of a tarsorrhaphy. Rehabilitation may involve improving the position of the eyebrow, upper eyelid, lower eyelid, or midface. Epiphora has a multitude of potential causes in the patient with a facial paralysis including reflex tearing, eyelid malposition, and a defective lacrimal pump. Patients with a coexisting trigeminal nerve palsy or neurotrophic cornea are at a heightened risk of ocular morbidity and must be treated as so. The purpose of this chapter is to review the evaluation and management of the ocular concerns in a patient with facial nerve paralysis.

Keywords

Lagophthalmos Exposure keratopathy Brow ptosis Eyelid retraction Paralytic ectropion Scleral lens Synkinesis Tarsorrhaphy Epiphora 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Section of Ophthalmology, Department of Head and Neck SurgeryThe University of Texas M.D. Anderson Cancer CenterHoustonUSA

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