How Bell’s Palsy Affects the Eyes

Bell’s Palsy And Your Vision

In addition to temporarily paralyzing the muscles in your face, Bell’s palsy may also cause some distressing changes to your eyes. Fortunately, your ophthalmologist offers treatments that will improve your comfort and protect your eyesight.

What Is Bell’s Palsy?

Bell’s palsy happens when a nerve that controls facial muscles becomes inflamed. The inflammation weakens the muscles that control your eyelid or prevents them from moving. Doctors believe that Bell’s palsy could be caused by viruses responsible for a variety of illnesses, including chickenpox, cold sores, shingles, mumps, German measles, the flu, genital herpes, pneumonia, or hand-foot-and-mouth disease.

Symptoms of Bell’s palsy can include:

  • Facial sagging on one side of your face
  • Drooping mouth
  • Lopsided smile
  • Inability to raise your eyebrows
  • Headache
  • Loss of feeling on the affected side of the face
  • Drooling
  • Loss of taste
  • Difficulty eating or drinking
  • Trouble pronouncing some sounds
  • Stiff neck
  • Fever
  • Sensitivity to noise

Bell’s Palsy and Dry Eye

Bell’s palsy may make it difficult or impossible to blink or close your eye and could also cause your lower eyelid to droop. As a result, your eye may become too dry and you might experience:

  • A stinging or burning sensation in your eye
  • Redness
  • Light sensitivity
  • A feeling that something is stuck in your eye
  • Stringy mucus

A dry eye is more than just an annoyance. In fact, dry eye increases your risk of developing a corneal ulcer, a painful sore on your cornea. The cornea, the clear, rounded tissue over your pupil and iris, bends the light rays that enter your eyes and keeps germs, dirt, dust, and debris from entering your eyes. If the ulcer scars your eye, your vision could be affected. Keeping your eye moist will reduce your risk of an ulcer.

Watery Eyes Can Be a Problem If You Have Bell’s Palsy

A watery eye is one of the more annoying symptoms of Bell’s palsy. Excessive tearing can be related to:

  • Dry Eye. When your eye becomes too dry, your tear glands go into overdrive and flood your eyes with tears.
  • Weakness or Paralysis of the Orbicularis Oculi Muscle. This muscle makes it possible to close your eyes and also helps move tears from your eyes to the nasolacrimal duct system. Tears constantly drain through the ducts into your nose. When the orbicularis oculi muscle is paralyzed or weak, tears build up in your eye instead of draining.

How Are Eye Problems Treated?

Your ophthalmologist can recommend several treatments and strategies that will make you more comfortable, including:

  • Lubricating Eye Drops and Ointments. Eye drops will keep your eye comfortably moist during the day. During the night, the ointment may be a better option, as it keeps your eye lubricated longer than drops.
  • Patching the Eye. Sleeping can be difficult when you can’t close one eye. Patching the eye may make it easier to sleep and also keep your eye from drying out when you sleep. Before you put the patch on, you’ll apply drops or ointment.
  • Medications. Corticosteroids decrease nerve inflammation and may help speed your recovery from Bell’s palsy. Anti-viral medication can also be helpful if your symptoms are severe, according to UpToDate.

If you develop a corneal ulcer, your ophthalmologist can prescribe pain medication. They may also give you antibiotic, antifungal, or antiviral eye drops. In most cases, corneal ulcers heal without causing scarring. If a scar does form, you may need a corneal transplant if the scar interferes with your vision.

Are you struggling with eye issues due to Bell’s palsy? Contact our office to schedule an appointment with an ophthalmologist.


All About Vision, Bell’s Palsy: Symptoms, Risks, Diagnosis and Treatment, 1/22

UpToDate: Patient Education: Bell’s Palsy (Beyond the Basics)

Korean Journal of Ophthalmology: Ophthalmologic Clinical Features of Facial Nerve Palsy Patients, 2/1/19

National Institute of Neurological Disorders and Stroke: Bell’s Palsy Fact Sheet