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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 10771
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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i have bells palsy on the left side of my face for exactly

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i have bell's palsy on the left side of my face for exactly one week now. in addition to this, my left eyelid won't close all the way, my left eye is always tearing and it feels uncomfortable. yesterday, went in for a neck ultrasound because i was told my hypothyroidism might be causing eye bulging. labs from thyroid say my perixidase levels are high. in the meantime, the drops Refresh advanced, given by my eye doctor are not helping the tearing. i need advice on how to relieve the eye discomfort please
thanks a lot

Dr. Rick :

Hi. I'm online and happy to answer your question today.

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Customer: replied 4 years ago.

hello. are you there?

Customer: replied 4 years ago.

hello?

Darn! My entire post was eaten by the Gremlins that live in the computer. Let me retype it all again :(

Please give me a few moments....sorry about that
Customer: replied 4 years ago.

okay

The first thing you can do is switch to an ointment, such as Refresh PM or lacrilube. This will work better then the drops but will also blur your vision.

If this doesn't work you can use medical tape to tape your eyelids closed. This is especially helpful at night.

If that doesn't work you can have a temporary lateral tarsorrhaphy. This is done in the doctors office under local anesthesia where a removable suture is placed so as to mostly close your eyelids, keeping them open just enough so you can see. This is very safe, 100% reversible when your Bells Palsy wears off and works extremely well.

Using this step-wise approach I am sure you can get relief from your symptoms and protect your eye from drying out. Of this, I have no doubt.

Does this answer your question?

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Let me know if you have further questions.

Let's see if the Gremlins leave my answer alone this time ;-)
Customer: replied 4 years ago.

i already alternate use of refresh advanced drops and the gel.

could this cause permanent damage?

also, what about the proptosis and the high peroxidase? is the eye bulging because of the palsy or because of the thyroid issues?

Bells palsy almost never causes permanent damage and, as you already might know, resolves in the vast majority of cases within 4 to 6 months.

Keeping your eye moist, however, is very important. Should your eye dry out a lot, get an epithelial defect, which then progresses to a corneal ulcer...this could be a problem and lead to long term eye damage.

This is why it is so important to protect your eyeball with the treatments I've discussed.

Do many patients have this "bad" outcome from Bells Palsy? No. But in over two decades of practicing ophthalmology, I have seen it occur.

Does this make sense to you?
Customer: replied 4 years ago.

makes sense, but do you think that the high peroxidase have something to do? so far, they've the eye doctor and primary doctor told me that the palsy has reduced movement of the lid but there's some bulging of the eye.


 

I do not think it is related to the high peroxidase.

Bulging of the eye is a simple thing for the eye doctor to check using a tool called a hertel exophthalmometer.

If your eye doctor is not an ophthalmologist (eye MD) you should change to one.

Thyroid eye disease and/or slight bulging of the eyes is not normally associated with bells palsy.


It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I don't go up in a puff of smoke -- I'll still be right here to continue helping you at no additional charge :-)
Customer: replied 4 years ago.

alright, thanks. to summarize what you've said so far:

 

1. i should continue to use the drops and the gel and consider that procedure you suggested. must keep eye moisture to prevent damage

 

2. palsy/thyroid and bulging are not related

 

...forgot to mention my job requires most of my time on the computer :( makes it even harder on my eyes

 

right?

Yes to #1.

Normally they are not related so an equivocal Yes to #2 :)

Feel free to mash the excellent feedback button should you so desire ;-)
Customer: replied 4 years ago.

thank you very much. enjoy your day.

My pleasure. You too.