"We suggest to use the temporary eye lid weight using the double sided tape so that it stay over the eye lid, newer implant made of 24K gold, they donot give any allergy and reaction to skin and very comfortable, front or anterior surface of eye lid weight is coated with silicone in skin shades to mimics normal" 


Kit of temporary eye lids implants with adhesive

The great advantage with these implant you can use the night time, and no surgery involved, which is very easy to use.
As the facial nerve carries sensory, motor and parasympathetic fibres involved in facial muscle innervation, facial palsy results in functional and cosmetic impairment. It can result from a wide variety of causes like infectious processes, trauma, neoplasms, autoimmune diseases, and most commonly Bell's palsy, but it can also be of iatrogenic origin. The main ophthalmic sequel is lagophthalmos. The increased surface exposure increases the risk of keratitis, corneal ulceration, and potentially loss of vision. Treatment options are wide; some are temporary, some permanent.
 
Above image just for illustration how does lagophthalmos leads to corneal exposure and lower lid sclera congestions

As the facial nerve carries sensory, motor and parasympathetic fibres involved in facial muscle innervation, facial palsy results in functional and cosmetic impairment. Facial palsy can result from a wide variety of causes, Bell's palsy (idiopathic) being the most common (70%) [1], but it can also result from infectious processes, trauma, neoplasms, autoimmune diseases, and it can be of iatrogenic origin [2].

The prognosis of the paralysis has been proven to depend on the cause of nerve damage: traumatic and iatrogenic lesions have less chances of functional recovery, while most patients with Bell's palsy show complete recovery without intervention within 3-4 months [1]. The main ophthalmic sequel is lagophthalmos, or the inability to close the eyes completely. The paralytic orbicularis oculi muscle is unable to promote eyelid closure and with the counterpart force offered by the normal-functioning levator muscle and the effect of laxity and gravity in the lower eyelid, the corneal protection is compromised. The increased surface exposure and the disruption of the tear film put the eye at risk of keratitis, corneal ulceration, and potentially vision loss.

There are several ways to address paralytic lagophthalmos in these patients; some are temporary, some permanent. The decision is based on the clinical examination and basically on the exposure risk of the cornea.

Above image is illustrate the how the gold weight,how it is placed

Non-Surgical or Temporal Therapy

Temporary and non-surgical measures aim to protect the ocular surface while recovery is awaited. They traditionally include the frequent use of artificial tears, ophthalmic ointments, soft contact lenses, protective taping, occlusive moisture chambers, scleral shells and external eyelid weights [2,3], but new options are constantly being reported.

The American Academy of Otolaryngology and the American Academy of Neurology strongly recommend the use of oral steroids in adults (16 and older) within 72 h of symptom onset for Bell's palsy as it increases the probability of facial function recovery. The use of antivirals is only recommended if associated with steroids as its benefit is not so clear [4,5].

Regarding rehabilitation techniques, the role of acupuncture as an alternative or adjunct therapy in facial palsy is unproven [6], but mime therapy [7] was found to be effective in improving the functional outcomes (fig. 1). It includes exercises of self-massage, relaxation and breathing, combined with the performance of movements of the face and the pronunciation of letters and words.

We suggest to use the temporary eye lid weight using the double sided tape so that it stay over the eye lid, newer implant made of 24K gold, they donot give any allergy and reaction to skin and very comfortable, front or anterior surface of eye lid weight is coated with silicone in skin shades to mimics normal, 

The great advantage with these implant you can use the night time, and no surgery involved, which is very easy to use.

Above image just for illustration how does this help for the patient.

Conclusions:

There is no perfect way to treat lagophthalmos in patients with facial palsy. Many factors need to be tak- en into account, such as the recovery expectation, age, the degree of lagophthalmos and orbicularis function, Bell's reflex, etc. Each patient requires an individualized approach, most of the time involving two or more different techniques in order to achieve ocular comfort and protection as well as good aesthetic outcome. Knowing all available options is always in favour of our patients.