Irreversible paralysis, eye complex

Paralysis of the eye complex results in brow ptosis, inability to close the eye, and lower eyelid laxity.

Brow ptosis may result in asymmetry and loss of visual field (upper-lateral gaze).

Upper eyelid paralysis inhibits eye closure, resulting in corneal dryness and exposure.

Patients will experience excessive tearing, blurred vision, and pain. Prolonged corneal exposure without appropriate treatment may lead to ulceration and blindness.

Lower eyelid paralysis leads to lid laxity, which may result in ectropion. This further worsens tearing.

Paralysis of the eye complex results in brow ptosis, inability to close the eye, and lower eyelid laxity.

Brow ptosis may result in asymmetry and loss of visual field (upper-lateral gaze).

Upper eyelid paralysis inhibits eye closure, resulting in corneal dryness and exposure.

Patients will experience excessive tearing, blurred vision, and pain. Prolonged corneal exposure without appropriate treatment may lead to ulceration and blindness.

Lower eyelid paralysis leads to lid laxity, which may result in ectropion. This further worsens tearing.

Skill level

Equipment

Main indications

Corneal exposure

Further indications

Temporary and/or preemptive measure prior to definitive procedure to improve eyelid function and ensure corneal protection
Emergency measure when definitive treatment is delayed or there is possibility of imminent visual loss due to exposure
Salvage procedure when other treatments have failed
Poor or absent Bell's phenomenon

Advantages

Simple
Quick
Immediate result
Local anesthetic
Adjustable
Reversible

Disadvantages

Not dynamic
Poor cosmesis
Reduced visual field

Corneal exposure

Further indications

Temporary and/or preemptive measure prior to definitive procedure to improve eyelid function and ensure corneal protection
Emergency measure when definitive treatment is delayed or there is possibility of imminent visual loss due to exposure
Salvage procedure when other treatments have failed
Poor or absent Bell's phenomenon

Advantages

Simple
Quick
Immediate result
Local anesthetic
Adjustable
Reversible

Disadvantages

Not dynamic
Poor cosmesis
Reduced visual field

Skill level

Equipment

Main indications

Brow ptosis

Further indications

Eyebrow ptosis resulting in asymmetry with cosmetic deformity
Severe ptosis resulting in visual field impairment secondary to excess upper eyelid skin

Advantages

Simple
Quick
Immediate result
Local anesthetic
Repeatable
Low rate of relapse

Disadvantages

External scar
Not dynamic

Note: This is the most efficient way to raise the eyebrow when the frontalis muscle is paralyzed. Other techniques such as mid-forehead lift, coronal incision, and endoscopic brow lift require more surgery and have higher rates of relapse.

Brow ptosis

Further indications