My Eye is Smaller on the Bells Palsy Side and Very Uncomfortable, What To Do?

Question

i try to pull it open all the time as it is uncomfortable.like pressure on it.the whole palsy side has pressure,nose,mouth,when i eat it closes and waters tremendously help me

Mehryar (Ray) Taban, MD, FACS · Answer

The eye appears smalller on the Bells palsy side because the brow is paralyzed and droopy and it is crowding the eye area. The eye also is unlikely to blink well and close completely, which causes the eye to dry out and get irritated. There are various nonsurgical and surgical options. Consult an oculoplastic surgeon.

Steve Laverson, MD, FACS · Answer

Bell's palsy, and in fact any facial nerve paresis/dysfunction, are extremely difficult, both physically and psychologically.  Because multiple functions of the facial nerve may be affected, and because every individual is uniquely impaired, you truly need to seek in person help from a specialist.  The House Clinic in LA manages facial nerve disorders, and may be of help.  In Palm Springs, consider seeking referral to a neurologist, neurosurgeon, otorhinolaryngologist, or plastic surgeon with experience in facial nerve disorders.  Eisenhower is an excellent facility, and very well staffed.  

	The facial nerve innervates submandibular and sublingual salivary glands, but not the lacrimal... your excess lacrimation may be from irritation, reflex, or a pathway I'm unaware of.  Because the condition is serious, again, direct these questions to a physician who knows you, or seek a qualified specialist.

Adam Bryce Weinfeld, MD · Answer

synkinesis describes multiple muscles of the face working together but in a disorganized/less funciont manner. this can happen after bells palsy. another thing that can happen is hyperkinsis where the muscles are too active, again in a less than functional manner. selective injections of botox can at times be used to address these problems. a visit with a plastic and reconstructive surgeon might provide some answers.

Andrea Nowonty Hass, MD · Answer

The Bell's Palsy weakens your ability to blink and close your eye which leads to dryness that can make you very uncomfortable. Use lots of lubrication such as eye drops and eye lubricating ointment. You may also find it helpful to tape or patch the eye closed at night, but be careful to make sure the eye is truly closed under the tape or patch or you could give yourself worse problems!.

	If the bell's Palsy is of recent onset, you may see significant recovery over the next several months. Depending on how well you can keep the eye lubricated, you may be able to ride it out, or you may need some minor eyelid surery to help get you through these next several months. See a local oculoplastic surgeon for help. If you can't find one, your ophthalmologist (eye doctor) should be able to recommend one.

Sam Goldberger, MD · Answer

There may be many things going on making you feel uncomfortable. Some may be coming from the paralysis and some perhaps from the eye. It is best to see an Oculoplastic surgeon who can evaluate everything and give you a recommendation.

Edwin Ishoo, MD · Answer

The most important and urgent consideration is to protect the eye on the side of the weekness from drying and corneal abrasion. Eye closure is affected in Bells Plasy but not eye opening. Frequently a gold weigth can be implanted on the upper lid to allow passive closure of the eye and to protect it especially when asleep. Bells Palsy is a diagnosis of exclusion and needs to be evaluated, managed and followed thoroughly by a neurologist or an Otolaryngologist. Hopefully you will have full or some recovery of function but the eye function must be monitored closely to avoid permenant damage.

My Eye is Smaller on the Bells Palsy Side and Very Uncomfortable, What To Do?

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