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Eye Health Library / Eye Exam & Diagnoses
Bell’s palsy is a common condition that results from the paralysis of the facial nerve. It usually only affects one side of the face including the forehead and lower facial areas. Several physical manifestations of Bell’s palsy include difficulty closing one eye, slurred speech, drooping of one corner of the mouth, inability to whistle, drooling when drinking, or a wrinkle-free forehead all on the same side.
Bell’s palsy can start very rapidly. Men and women are affected equally. Most cases occur between the ages of 20 and 40. It usually takes close to three weeks for the symptoms to reach their maximum effect. Then, most cases recover over the next three weeks. Severe cases can take up to six months to resolve completely. Typically, there are very few, if any, permanent manifestations. However, the longer the recuperation, the more likely the risk of incomplete recovery. Patients over the age of 60 are at a greater risk of being left with long-term effects of Bell’s palsy.
Several conditions can be linked to Bell’s palsy such as herpes simplex infections, viral or bacterial infections, shingles, Lyme disease, upper respiratory tract infections, fever, dental surgery, exposure to extreme cold, or menstruation. In most cases, the cause is unknown.
Blinking is required to spread fresh tears across the eye and to reduce the evaporation of tears from the eye into the atmosphere. Since patients affected by Bell’s palsy cannot blink one eye, the cornea (clear cover of the eye) becomes dry resulting in ocular discomfort and damage. The lack of tears covering the cornea causes the eye to become red and irritated. If untreated, it can lead to corneal scarring, secondary infections, and even vision loss.
Treating the ocular effects of Bell’s palsy requires frequent use of artificial teardrops during the day and artificial tear ointments at bedtime to keep the cornea moist. Some patients need to wear an eye patch or tape their lids shut while sleeping for added relief and corneal protection. In more severe cases of dry eye due to Bell’s palsy, there are a couple of non-permanent surgical options available. There is some debate in the medical community regarding the role of oral antiviral and corticosteroid medications in treating Bell’s palsy. Bell’s palsy can be a very frustrating and painful condition to endure. For those where recovery is not complete, the change in the appearance of one’s facial features can be a dramatic change. Fortunately, most recover completely with no increased chance of reoccurrence.
Authored by: Dr. Stephen Taylor