The ocular surface and meibography in unilateral facial paralysis

Facial paralysis (FP) often leads to ocular surfacedisorders due to delayed or incomplete blinking.

This study aimed to evaluate the ocular surface andmeibomian glands (MG) in patients with unilateral FP.

A total of 26 patients with unilateral FP were included.Invasive tear film break-up time (TF-BUT), ocular surface staining score,Schirmer II test, total eyelid score, and MG secretion score were assessed.Non-contact meibography was used to evaluate the percentage of MG loss area,meiboscore, and morphological features (thickening, thinning, tortuosity,fluffy areas, shortening, ghost areas) of the MGs.

TF-BUT and Schirmer II test values were significantlylower in the FP group (p < 0.001 and p = 0.001, respectively). The Oxfordstaining score, MG expressibility score, and total eyelid score weresignificantly higher in the FP group (p < 0.001, p = 0.003, and p = 0.005,respectively). Meiboscore values were higher in both the upper and lowereyelids in the FP group compared to the control group, with a statisticallysignificant difference only in the lower eyelid (p = 0.270 for upper and p = 0.039 for lower). The presence of MG thickening wasremarkable in the FP group. The House-Brackmann grade was identified as theonly independent factor affecting both upper and lower eyelid meiboscores.

Facial paralysis impairs ocular surface parameters andincreases lid margin abnormalities. It is associated with higher meiboscoresand deterioration in meibomian gland morphology.