Neurológia pre prax 2/2023

Ocular complications of peripheral facial nerve palsy and their therapeutic possibilities

Peripheral lesion of the facial nerve leads to ipsilateral palsy of facial muscles. Weakening of the orbicularis oculi muscle results in inability to close the eyelids, i.e., lagophtalmos. As a result of lagophtalmos, the lower parts of the eye surface dry and cause a formation of exposure keratopathy of variable severity. Chronic corneal changes lead to development of vascularized corneal scar, which permanently deteriorates the visual acuity. Immediately after the diagnosis of peripheral facial nerve palsy by the neurologist, frequent application of ophthalmic lubricants and an early ophthalmological examination are recommended. The treatment of eye complications depends on the character of corneal involvement and extent of lagophtalmos, considering the possibility of its spontaneous restitution. The therapy is surgical in serious cases, aimed at adjusting the position of the eyelids, and in case of a non-healing corneal ulcer, the amniotic membrane transplant is indicated.

Keywords: peripheral facial nerve palsy, ocular complications, lagophtalmos, tarsorraphy, corneal ulcer, amniotic membrane