Eye care

The most common problem associated with facial muscle weakness is incomplete closure of the eyelid. This may lead to exposure keratitis and corneal ulcers.

Two strategies should therefore be employed:

• Hourly lubricating eye drops during the day and eye ointment at night
• Eye taping at night

In addition, patients must be told to report new eye symptoms, such as pain, discharge and change in vision.

Patients with incomplete eye closure should be referred for ophthalmology follow-up as further options, including temporary tarsorrhaphy or botulinum toxin tarsorrhaphy, are available.

Learning bite

Eye care is extremely important in the management of Bell’s palsy as ophthalmological complications are common.

Attempts have been made to reduce facial muscle weakness with physiotherapy, electrical stimulation and acupuncture. None have high quality evidence to support their routine use [17, 18, 19].