Eye Discomfort & Eyelid Issues
Facial nerve weakness can cause decreased or inadequate closure of the eye, and a degree of facial paralysis can also reduce the flow of tears from the tear gland. These two issues together can result in an unhealthy surface of the eye leading, if neglected, to visual impairment or loss of vision. Thus, care of the eye following facial paralysis is of the utmost importance and should never be delayed or deferred. If the problem is acute, you should attend your local eye casualty to get urgent assistance; otherwise, a referral to an eye specialist will suffice (your acoustic neuroma team will usually be able to make such a referral, preferably to an eye specialist with expertise in eye-lid reconstruction (called oculoplastic surgeons).
Acoustic neuroma patients with eye problems may consider taping the eye closed at night, to offer protection to the eye during sleep, or applying special eye dressings. A dry eye can benefit from artificial tears. Sensitivity to light may be countered by wearing dark or tinted lens glasses. Excessive tearing of the affected eye at the sight, smell and taste of food may produce ‘crocodile tears’ which can be troublesome.
With facial nerve palsy, the eye-lids may not close properly, placing the cornea of the eye at risk of exposure or ulceration. A number of surgical procedures are available to address this important problem and you should discuss with your doctors. In some instances, small weights are inserted into the upper lid of the affected eye to assist closure by way of gravity; improvements may also be made with Botox injections.
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