Sunday, January 29, 2012

Droopy lower eyelid from facial paralysis

This old man developed a left facial palsy about one year ago. Despite investigations including brain scan, no cause was found. Bell's palsy is the name given to facial palsy of unknown cause. In the majority of cases, the palsy resolves with time but this patient unfortunately failed to do so. The facial palsy caused problem with his eyelid closure and the left eye was always uncomfortable because of exposure (Figure 1). In severe cases, such exposure can cause problem with vision. To alleviate the discomfort, the lower eyelid needs to be repair to avoid better eyelid closure. In this case, the best procedure was to shorten the lower eyelid using lateral tarsal strip procedure (See Figure 2).

Figure 1. Left facial palsy causing droopy eyelid
and ocular exposure.

Figure 2. Lateral tarsal strip. In this procedure,
the lower eyelid was shortened and tightened to
treat the droopy eyelid.

After the procedure, the appearance of the lower eyelid improved and the exposure and discomfort were reduced (Figure 2).

Figure 3. Immediately after the operation.

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