Scleral Contact Lens Application In Facial Paralysis: A Case Series

Facial paralysis often leads to incomplete eyelid closure, resulting in corneal exposure, inadequate lubrication, and subsequent complications such as exposure keratitis and corneal ulcers. Scleral contact lenses have emerged as a promising therapeutic option to address these issues by providing protection and hydration to the ocular surface. The objective is to evaluate the efficacy of scleral contact lenses in managing corneal complications in three cases of patients with facial paralysis. 

Instituto de Microcirugía Ocular (IMO Barcelona) Grupo Miranza C/ Josep Maria Lladó, 3, 08035 Barcelona (Spain).

A case series of patients with facial paralysis and associated corneal exposure symptoms were fitted with scleral contact lenses. Outcomes assessed included improvement in corneal hydration, reduction in exposure keratitis, and healing of corneal epithelial defects. 

Following scleral lens wear, all patients demonstrated significant improvement in corneal hydration, with a marked reduction in exposure keratitis symptoms. All three patients demonstrated significant improvements in visual acuity, with best-corrected visual acuity (BCVA) improving by an average of 6 lines on the Snellen chart. Additionally, pre-existing corneal epithelial defects showed complete healing. Patients reported enhanced comfort and visual stability. 

Scleral contact lenses are an effective therapeutic modality for managing corneal complications in facial paralysis. They improve visual acuity, corneal hydration, reduce exposure keratitis, and promote the healing of corneal wounds, offering a valuable non-surgical option for these patients.