Ophthalmologic Clinical Features of Facial Nerve Palsy Patients

Abstract

Purpose: To understand the ophthalmic clinical features and outcomes of facial nerve palsy patients who werereferred to an ophthalmic clinic for various conditions like Bell’s palsy, trauma, and brain tumor. Methods: A retrospective study was conducted of 34 eyes from 31 facial nerve palsy patients who visited aclinic between August 2007 and July 2017. The clinical signs, management, and prognosis were analyzed. Results: The average disease period was 51.1 ± 20.6 months, and the average follow-up duration was 24.0 ±37.5 months. The causes of facial palsy were as follows: Bell’s palsy, 13 cases; trauma, six cases; brain tumor,five cases; and cerebrovascular disease, four cases. The clinical signs were as follows: lagophthalmos,24 eyes; corneal epithelial defect, 20 eyes; conjunctival injection, 19 eyes; ptosis, 15 eyes; and tearing, 12eyes. Paralytic strabismus was found in seven eyes of patients with another cranial nerve palsy (including thethird, fifth, or sixth cranial nerve). Conservative treatments (like ophthalmic ointment or eyelid taping) wereconducted along with invasive procedures (like levator resection, tarsorrhaphy, or botulinum neurotoxin typeA injection) in 17 eyes (50.0%). Over 60% of the patients with symptomatic improvement were treated usinginvasive treatment. At the time of last following, signs had improved in 70.8% of patients with lagophthalmos,90% with corneal epithelium defect, 58.3% with tearing, and 72.7% with ptosis. The rate of improvement forall signs was high in patients suffering from facial nerve palsy without combined cranial nerve palsy. Conclusions: The ophthalmic clinical features of facial nerve palsy were mainly corneal lesion and eyelid malposition,and their clinical course improved after invasive procedures. When palsy of the third, fifth, or sixtycranial nerve was involved, the prognosis and ophthalmic signs were worse than in cases of simple facialpalsy. Understanding these differences will help the ophthalmologist take care of patients with facial nervepalsy.