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Bell's PalsyGeneral InformationBell's palsy is a sudden, usually unexplained, paralysis of the facial muscles. This paralysis causes a characteristic drooping of one side of the face. There are three especially noticeable signs of this condition; one corner of the mouth sags, the lower eyelid sags on the same side, and there is often a loss of the normal blink of that eye as well. The loss of the eyelid blink and the protective covering provided by the lid are potentially very dangerous for the eye. The function of the eye absolutely requires surface moisture provided by the tear-film. The eyelids are critical to spread the protective tears and their nutrients over the clear cornea and eye surface. Without normal eyelid function and the tear-film, the surface cells begin to dry out and die, making it vulnerable to ulceration, scarring, infection, and even loss of the eye. Bell's palsy is most usually "self-limited," resolving without treatment over a period of weeks or months. Until this palsy or partial paralysis resolves, it is very important to aid in the protection of the eye surface. Depending upon the degree of eyelid paralysis and loss of lid blink, treatment is suggested. Artificial tears and ophthalmic ointments are important to use, frequently, during the day and, liberally, at bedtime. In extended cases, taping the eyelids closed may be required to protect the eye's vulnerable surface. Similarly, it may be necessary to hold the eyelids together in a more normal relationship through minor surgery called a tarsorrhaphy. This may be only a temporary measure to protect the eye until normal lid function returns, allowing the surgery to be reversed and the lids to be fully opened. It is most important to remember that Bells palsy usually goes away without treatment within weeks to months. During this time it is of the utmost importance to protect the eye surface with lubricants to prevent permanent scarring and loss of vision.
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