A patient with facial nerve palsy may be at risk for corneal damage which can result in significant visual impairment and even loss of sight in the affected eye. Meadows et al identified risk factors for significant corneal damage in these patients. The authors are from Southampton Eye Unit in the United Kingdom.
Risk factors for corneal damage:
(1) significant lagophthalmos (measured as the amount of globe exposed when trying to fully close the eyelids, in mm)
(2) poor upper eyelid closure
(3) corneal anesthesia
(4) poor tear production
(5) poor compliance with recommendations for eye care (application of ointments, lid closure at night, eye protection)
(6) poor Bell's phenomenon (rolling of the eye laterally and superiorly when eyelid closes)
A patient with one or more of these risk factors may benefit from more aggressive management.
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