Weakness of the facial nerve (cranial nerve 7) can be associated with Bell’s palsy, a viral infection, genetic predisposition, and traumatic injuries to the facial nerve, e.g. excision of acoustic neuroma. Facial nerve palsy can cause severe, vision- and eye-threatening complications secondary to corneal exposure. When the eyelids cannot protect the cornea, the cornea dries out and can become infected and perforate.
Sometimes the palsy is temporary, and other times will require surgical intervention to protect the cornea and restore eyelid function. Other treatments for associated complications of the palsy, such as ticks and spasms, may include chemodenervation with Botox. Each patient’s needs are very unique and require an individualized approach to treatment.