A small weight is placed in the upper lid so that the eye can close fully and the surface stays protected.
What it is
When facial weakness stops the eye closing, the surface dries and can be damaged. A thin gold or platinum weight, placed inside the upper lid, lets gravity close the lid gently.
The operation
The weight is measured with you beforehand, then placed through a cut in the natural crease of the lid.
It takes about 45 minutes under local anaesthetic, as a day case. It can be removed or exchanged later if your facial movement returns.
What it does not do
The weight helps the lid close. It does not restore facial movement.
Who it can help
It may suit you if helps the eye close fully to protect its surface is what you notice most, and you are otherwise well.
- An eye that does not close fully, especially at night
- A sore, red or gritty eye on the weak side
- Constant use of ointment to protect the eye
- Facial weakness that is not expected to recover soon
Where the lower lid also sags, tightening it at the same time usually helps.
Recovery and risks
Everyone heals at their own pace. This is a typical course, and your consultant will tell you what to expect in your case.
The first two days
Swelling and bruising are at their most noticeable. Rest with your head raised and use cold compresses.
The first week
The lids feel tight or gritty. Stitches, where they are used, come out at about seven days.
Weeks two and three
Bruising fades. Many people are back at work and comfortable being seen.
Three to six months
Scars settle and soften. Your final review is around this time.
Possible risks
Every operation carries some risk. For eye closure surgery for facial palsy these include:
- Dry or irritated eyes, usually temporary
- A small difference between the two sides
- A visible or thickened scar
- Infection or bleeding, which are uncommon
- Very rarely, a change in your vision
Your surgeon will go through the risks that apply to you, and give you written information to take home.
Insurance
Eye closure surgery for facial palsy is sometimes covered when the problem affects your health or your vision. Surgery for appearance alone is not.
Check your cover with your insurer before your consultation, and your surgeon will supply what they need.
Questions patients ask
Can you see the weight?
It sits inside the lid. A slight fullness in the crease is common, and your surgeon chooses the thinnest weight that will do the job.
Can it be removed?
Yes. If your facial movement recovers, the weight can be taken out.
Is it safe with MRI?
Gold and platinum weights are MRI safe. Tell the radiographer you have one.
Is it covered?
Usually yes. This protects the eye.