Eyelid gold weights in the management of facial palsy

We reviewed our experiences with 20 patients with established facial palsy who had a total of 24 gold weights inserted. All patients had corneal symptoms: ulceration, exposure keratitis or discomfort abolished. Functional improvement i.e. reduction of lagophthalamos and restoration of the blink reflex was good in our opinion and that of the patients in all cases. Dissatisfaction with the cosmetic result was expressed by two patients due to the prominence of the weight under the thin eyelid skin. Three patients had to have the weight replaced because it was too light. Two patients had their weights removed because of recurrent eyelid infections. In two patients the weights were removed as they had migrated over the tarsal rim. In one of these patients the weight was replaced immediately in the appropriate position, in the other it was not replaced as dissatisfaction had been expressed due to the bulky appearance of the weight under the eyelid skin.