The loss of eye closure blinking is one of the most significant problems associated with Bell’s palsy/Facial paralysis. Disruption of this protective mechanism can lead to irritation of the eye (conjunctivitis), ulceration of the cornea (exposure keratitis) and blindness. Lubrication of the eye is initially achieved with artificial tears, lubricants and taping the eye closed at night. If the ability to close ones eye does not return then a more permanent solution is required. Eye closure and blink can be reestablished utilizing an implantable gold weight in the upper eyelid. Fortunately ones ability to open the eye is not controlled by the facial nerve and usually remains unaffected by most causes of facial paralysis. This combination of active opening and gravitational closure can be very effective in simulating normal eyelid function.
The procedure is initiated by selecting the proper size weight. Α series of weights are secured to the upper eyelid with two-sided tape to help determine the optimal size. The weight that produces rapid eye closure without the look or sensation of eyelid drooping (lagopthalmus) is selected.