Eye

FIGURES AND TABLES

FROM:

Ophthalmic management of facial nerve palsy

V Lee, Z Currie and J R O Collin

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Figure 1.

Paralytic ectropion with marked lagophthalmos on attempted eyelid closure.

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Figure 2.

Paracentral (pillar) tarsorrhapy.

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Figure 3.

Paralytic ectropion with marked lagophthalmos on attempted eyelid closure.

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Figure 4.

Good eyelid closure post tarsorrhapy.

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Figure 5.

This patient complained of poor cosmesis and restricted visual field from her lateral tarsorrhapy, despite adequate corneal protection.

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Figure 6.

The lateral tarsorrhapy was reversed and the upper lid lowered to decrease the palpebral aperture.

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Figure 7.

Marked lagophthalmos on attempted eyelid closure.

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Figure 9.

Complete eyelid closure post gold weight insertion—there is partial erosion of the gold weight.

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Figure 10.

Upper lid palebral spring.

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Figure 11.

Pre- and post-lateral canthal sling and medial canthal Royce–Johnston suture.

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Figure 12.

Pre- and post-lateral canthal sling and medial canthal Royce–Johnston suture.

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Figure 13.

The Royce–Johnston (RJ) suture. A double-armed 5/0 prolene passed from the tarsal plate, using a large-diameter free surgical needle supero-medially towards the periosteum of the posterior lacrimal crest. The suture ends were brought out through the skin, tied and buried.

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Figure 14.

The Royce–Johnston (RJ) suture. A double-armed 5/0 prolene passed from the tarsal plate, using a large-diameter free surgical needle supero-medially towards the periosteum of the posterior lacrimal crest. The suture ends were brought out through the skin, tied and buried.

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Figure 15.

Right aponeurotic ptosis in a patient with previous facial nerve palsy.

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Figure 16.

Exacerbation of the ptosis due to aberrant regeneration resulting in co-contraction of orbiculari oris & oculi.

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Figure 17.

Post hypoglossal–facial anastomosis. There is little sign of facial weakness at rest.

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Figure 18.

Post hypoglossal–facial anastomosis. Weakness of eyelid closure with lagophthalmos.

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Figure 19.

Post hypoglossal–facial anastomosis. Full eyelid closure is achieved when the patient moves his tongue to the contralateral side.

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Diagram 1.

Schemata for the ophthalmic management of facial palsy.

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