Facial muscles play a fundamental role in activities of which we are often unaware. Without them, we would not be able to chew our food, smile or show surprise. Most importantly, however, is their role in the protection of our eyes through what we call the blinking mechanism. Each blink distributes a healthy film of tears over the surface of the cornea, preventing this delicate tissue from drying out or becoming infected. The muscles responsible for carrying out this function are called the orbicularis oculi, while the facial nerve controls the movement of these muscles.
The facial nerves carry signals from the brain to individual muscle fibers on both sides of our face. When this signal is interrupted by swelling or permanent damage to a nerve, the muscles on that side of the face will become temporarily or permanently weak. This is a common medical condition known as facial paralysis.
Facial paralysis may be temporary, as when it is caused by a viral infection, or it may be permanent.
Bell’s palsy refers to facial paralysis that has no identifiable cause. Regardless of the causing factor, this condition usually results in the loss of a person’s ability to close the eyelids. If normal function is not restored, the eye is at risk of significant damage.
Treating the eye symptoms of facial paralysis
A weak blinking mechanism is responsible for causing ocular symptoms that affect patients with facial paralysis. The most common of these include eye irritation, constant tearing, foreign body sensation and debilitating pain. If left untreated, these symptoms can affect a person’s quality of life. In severe cases where the orbicularis muscle is significantly impaired, the cornea is at risk for scarring due to a lack of lubrication. Another risk associated with deficient eyelid closure is infection by aggressive bacteria that can cause irreparable corneal damage.
In young patients, symptoms can be managed with eye lubrication using preservative-free artificial tears and ophthalmic gels. Patients should also sleep with an eye patch or with special glasses that create a seal around the eyes to prevent the evaporation of tears. In older patients, lubricating the eye may not be enough to protect the cornea making surgery necessary. This is also true in cases where the facial nerve has been permanently damaged.
Surgical options for restoring eyelid function
When eyelid function has been permanently compromised or symptoms cannot be managed medically, a surgical option should be considered to preserve the integrity of the eye. Gold weight implants have been specifically designed to improve the blinking mechanism in patients with facial paralysis. These implants assist eyelid closure by assuming the function of a weak orbicularis muscle. The result is an improvement in dry eye symptoms, excessive tearing and ocular pain.
Oculoplastic surgeons are experts in gold weight implants for the management of the ocular symptoms due to facial paralysis. They tailor treatment for individuals by implementing various procedures in conjunction with gold weight implants in order to improve the quality of life for their patients while protecting the integrity of the eye.
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