Ocular prevention is the first and foremost priority in the management of the patient with facial paralysis. John J Chi presents a review on the management of the upper and lower eyelid in cases of the paralysed face. In the following sections, he offers detailed guides on clinical assessment, indications for surgical intervention, relevant anatomy and operative techniques for the upper and lower lid. The operative techniques are presented briefly, focusing on upper eyelid loading and lower eyelid tightening. In addition to these, the author shares pearls of wisdom and helpful tips on how to avoid common complications on both surgical procedures. The reader will learn specific terminology (e.g. MRD1 and MRD2, margin gap or palpebral fissure height), grasp a bit of the complex anatomy, and have a chance to use this article as a guide for future manoeuvres. The explanation of the surgical intervention of the upper lid is more detailed than the summary on the lower eyelid tightening procedure. Therefore, this article is of particular help as an introduction to any young surgeon, who is looking for an introduction to oculoplastic surgery.
Management of the eye in facial paralysis
Reviewed by Gregor M Bran
Management of the eye in facial paralysis.
