EYE CARE RECOMMENDATIONS FOR FACIAL PARALYSIS WITH INCOMPLETE LID CLOSURE

Day Care

1. eye drops for daily care    
As the affected eye tends to dry out due to incomplete eyelid closure and lack of blinking, it must be continuously moisturized with eye drops to prevent damage to the cornea and conjunctiva such as irritation, inflammation and even corneal detachment.

Instructions for use:    
Apply generously to the affected eye (2-3 drops) as required (up to several times an hour if necessary).

Example products:    
HyloComod eye drops
Or other pure saline solution without preservatives

2. contact lenses
In contrast to soft monthly contact lenses, soft annual contact lenses or hard contact lenses, soft daily contact lenses are very comfortable to wear as they are very thin.
However, a prerequisite for high wearing comfort is a well-moisturized eye, which makes the additional use of eye drops necessary if tear fluid production is reduced!
The great advantage of wearing contact lenses is that around 50% of the visible surface of the eye is protected from environmental influences of any kind (wind, pollen, cooking fumes, etc.), thus reducing or preventing irritation and inflammation of the affected eye.
If there is no visual impairment, a contact lens with only 0.5 diopters can be used. Due to the optical correction in only one eye, after a short familiarization phase (approx. 1 to 2 weeks), there should be no disturbing impairment of the quality of vision in daily life.

The following is a patient's account:
"In the case of existing visual impairment with astigmatism, a spherical contact lens (without cylinder) should be used on the paralyzed one. Correcting the astigmatism with a toric contact lens (with cylinder) only leads to a thicker contact lens with less wearing comfort. A slight loss of vision on the affected eye must therefore be accepted, but can be compensated for by a precisely fitted contact lens on the healthy side."

Contact lenses must always be fitted by an ophthalmologist or optician!

Instructions for use:
After getting up in the morning, carefully wipe the closed eye with a cotton pad moistened with lukewarm water to remove the remaining eye ointment from the night. When wiping, take care not to injure the eye (if necessary, close the eyelid with the fingers of the second hand).
Carefully clean the corner of the eye and the lower eyelid with a cotton bud moistened with lukewarm water.
Then wait at least half an hour (preferably 1 hour) until the remaining film of eye ointment has disappeared (the waiting time before inserting the contact lens prevents blurred vision caused by the eye ointment, which would last the whole day). During this time, eye drops can also be used generously. Then insert the contact lens into the affected eye.
If the contact lens becomes absorbed during the day because the eye was not moist enough, apply a generous amount of eye drops into the eye, close the eye and wait briefly. The lens can then be carefully moved with a finger to remove it from the eye.

Example product:    
Dailies Total 1

3. sufficient fluid intake throughout the day
Sufficient fluid intake throughout the day has a significant influence on the moistening of the eye.

Night Care

1. eye ointment for daily care
To protect the affected eye from drying out at night, an eye ointment should also be used here. This forms a protective film on the eye and prevents it from drying out.

Instructions for use
Pull the lower eyelid down a little with your finger. With the second hand, apply an approx. 2 cm long strip of ointment from the tube to the lower eyelid from the inside to the outside. Then pinch the eye closed briefly with your fingers to distribute the ointment well.

Example product:
Hylo Night eye ointment    
or other vitamin A ointment without preservatives.

2. adhesive tape
If the eye ointment is not sufficient to moisten the affected eye during the night, the open eyelid gap can be closed with a piece of adhesive tape during the night.
The advantage over the watch glass dressing (see point 1.3.) is a smaller adhesive surface with a more skin-friendly adhesive tape, which means that the skin is less irritated (e.g. rash formation, redness, etc.) during daily use.

Instructions for use:
Tear off a piece of tape approx. 5 cm long. Press the affected eyelid down with your fingers until the eyelid is completely closed. Then stick the tape vertically over the eye from top to bottom. The eye ointment should be used as a supplement.

Example product:
3M™ Micropore™ Hypoallergenic non-woven plaster 2.5 cm x 5 m
Or other skin-friendly adhesive tape

3. watch glass bandage
If the eye ointment and adhesive tape are not sufficient to moisturize the affected eye during the night, the affected eye can be protected from drying out during the night with a watch glass dressing. The watch glass dressing creates a protected, moist atmosphere by completely sealing the eye.

Instructions for use:
Lightly press the adhesive surface around the eye. To avoid wrinkling of the adhesive surface, it can be cut a few millimeters in two to three places and overlapped. The eye ointment should also be used here as a supplement.

Example product:
Pro-ophta watch glass bandage (available inseveral sizes)

Care products for eye inflammation

Regularly treat the eyes with antibiotic eye drops as described above. It is advisable to keep 2 to 3 packs of eye drops in stock at home so that treatment for eye inflammation can be started immediately. The ophthalmologist should still be consulted to clarify the cause of the inflammation.

Example product:
Dexa-Gentamicin eye drops (prescription only)

Conflicts of interest:
The authors declare that there are no conflicts of interest

Disclaimer:
No liability is accepted for any damage to health that may arise from the use of the above recommendations. Use is at your own risk.