Bell’s palsy can interfere with the ability to blink, close one eyelid, and produce tears, all of which can result in vision and eye complications. (Learn More)

As one of the main causes of facial paralysis, Bell’s palsy impacts the facial nerve and causes one side of the face to stop working or not move properly.

Bell’s palsy symptoms come on suddenly and include numbness, weakness, and even full paralysis, usually only on one side of the face. This paralysis affects the eye region as well. (Learn More)

Typically, Bell’s palsy clears up on its own. There are also medications and treatment options that your doctor can discuss with you to manage the condition and its symptoms. (Learn More)

The Effect of Bell’s Palsy on the Eyes

Bell’s palsy symptoms often come on very suddenly, leading to stiffness on one side of the face.

In rare instances, both sides of the face can be impacted, but most of the time, only one side is affected. Often, if the entire face is weakened or paralyzed, there is another issue or condition causing this.

The facial nerve is responsible for controlling facial expressions, eye blinking, and eye closing. It is also responsible for transmitting taste sensations from the tongue and carrying nerve impulses to the small bones of the ear, saliva glands, and tear glands. This means the eyes are greatly affected by Bell’s palsy.

The following symptoms may be present:

  • Facial muscle twitching around the eyes
  • Numbness around the eyes
  • Drooping around the eyes
  • Inability to close one eye
  • Excessive tearing in one eye
  • Dryness of the eye

Symptoms of Bell’s palsy can range from mild weakness to complete paralysis.

In 80 percent of people, symptoms of Bell’s palsy improve in three weeks and are completely gone in two to three months. In a minority of cases, Bell’s palsy and facial paralysis or distortion can become permanent or last longer, but this is not common.

Impact on Your Vision

Since Bell’s palsy can impact your ability to blink, close your eye, and produce tears normally, the condition can lead to severe dry eye. The muscle responsible for opening your eyelid is not impacted by Bell’s palsy, which is why your eye will remain open. You will be unable to blink or close your eye, even partially.

This can cause a condition called exposure keratitis or exposure keratopathy, which is an extreme form of dry eye that involves damage to the cornea from inadequate eyelid closure. This condition can lead to eye irritation, burning sensations, blurred vision, sensitivity to light, watering of the eye, and redness.

Scratches to the cornea, foreign objects getting into your eye, and trauma to the eye can occur when you are unable to close your eye properly. Blurry vision can also be a visual side effect of Bell’s palsy.

Managing the Condition

Around 30,000 to 40,000 people in the United States are affected by Bell’s palsy every year, and most of the time the condition is only temporary. If there is a specific and known cause that triggers the condition, that issue is dealt with first. However, most of the time, the cause is not clear.

Symptoms can clear up on their own without treatment, but it is very important to protect your eye. Your ophthalmologist can prescribe treatments that protect and lubricate the eye, such as the following:

  • Eye drops
  • Ointment
  • Eye patch at night
  • Moisture chamber at night

Using an eye patch or moisture chamber at night can protect the eye you are unable to close from potential trauma, drying out, or the cornea being scratched while you sleep.

An eye patch can protect the eye and make it easier to sleep by covering it and blocking light. A moisture chamber sits on your eye like a kind of goggle and helps to keep the moisture in as well as protect the eye from exposure. Eyelid weights are another option to help close your eye.

Talk to your ophthalmologist before using any of these treatments to ensure their safety and efficacy for your specific situation.

Additional Treatment Options

Other treatment options and methods for managing Bell’s palsy symptoms include:

  • Steroid medications to manage and decrease inflammation.
  • Antiviral medications if the cause is related to a viral infection.
  • Analgesic medications for pain relief.
  • Physical therapy or facial massage to relieve and stimulate the facial nerve.

Holistic and adjunctive treatment methods can be used in tandem with traditional medicine. These options for Bell’s palsy include:

  • Acupuncture to stimulate the optic nerve and promote blood flow.
  • Biofeedback to teach you how to control and manipulate bodily functions.
  • Electrical stimulation that sends gentle electrical pulses through the skin to stimulate nerves and relieve pain.
  • Relaxation techniques to calm the optic nerve.
  • Vitamin therapy, such as mineral zinc, B12, and B6 to enhance healing.

Treatment options will depend on the severity of your condition, your specific health history, and the potential cause of the onset of Bell’s palsy. It is highly important to keep your eye lubricated and protected from exposure, trauma, and foreign bodies.

Your ophthalmologist can help you decide on the best course of action for symptom management.

References

Bell’s Palsy. (August 2020). Optometrists Network.

Bell’s Palsy Fact Sheet. (October 2020). National Institute of Neurological Disorders and Stroke (NINDS).

Bell’s Palsy Symptoms. (March 2020). American Academy of Ophthalmology (AAO).

Emergency Management: Exposure Keratopathy. (2018). Community Eye Health Journal.

Bell’s Palsy. (2020). Bausch & Lomb.

Bell’s Palsy. (2020). John’s Hopkins Medicine.