Frequent manual manipulation of your upper eyelid

With a CLEAN finger, and usually easier with the back of your finger, locate your upper eyelid, which may very well be completely hidden under your drooping eyebrow.

GENTLY move it as it would normally move. A couple of times should be sufficient to recoat the cornea with your natural eye fluids. Do as often as is needed throughout the day.

Artificial tears or natural tears

The Oily layer is produced by the Meibomian glands, the Watery layer by the Lacrimal gland and the Mucus layer by the Conjunctiva

There are 3 components of each tear that lubricates your eye and each are in a certain balance with one another, namely, the outer oily layer, the middle watery layer and the inner mucous layer.

Artificial tears contain all of these components in the correct balance. They lubricate the eye in place of your tears.

Artificial tears are available without prescription and your optician or pharmacist will be able to tell you which they recommend. Due to brands differing in each country I cannot not recommend a particular brand.

Ask or look for a brand that claims it is “for sensitive eyes”, “preservative free” and/or “non-allergic” (hypoallergenic).

If you do find that your eye becomes more sensitive, or feels like it is stinging or burning, then stop using the drops and see your optician or pharmacist to recommend another brand without the offending ingredient to which you may be sensitive.

The thickness of the artificial tears, ranging from a thin solution, right through to a thick gel (especially useful for protecting the eye when sleeping) will determine how often you will have to apply the tears to your eye.

Don’t worry, it will not be every few seconds and is usually every couple of hours although more often is better.

Always read and follow the manufacturer’s instructions, or the advice of your optician or doctor.

Sunglasses

Because you will usually not have total control over your eyelid and therefore cannot blink or squint, sunglasses can provide quite a crucial role in solving some of the problems you will need to solve.

They will obviously protect your eyes from bright light, that is why they were designed. However, they will also do the following:

• Provide relief from constantly having to look away or down in bright light
• Provide some protection from dust and spray
• Provide some protection from wind and even the air that you move through whilst you walk indoors that can cause a dry eye
• Provide some privacy from people staring at your droopy eye anatomyThere are different designs that may help you more than a general pair:
• Wrap around ski goggles or cycling goggles are superb for Bell’s Palsy as they are protecting you on all sides from debris, wind and sunlight
• Clip on sunglasses are essential for people who wear glasses or have to wear glasses in place of contact lenses until they recover
• Prescription “light reacting” glasses are now reasonably affordable and get away from the problem of having to carry sunglasses or clip-ons around with you, and you can leave them on indoors and nobody will question this. “Light reacting” glasses change automatically, incrementally from normal glasses to sunglasses, as the light changes.

Moisture chambers

These are basically a protective chamber that help to stop the air from drying out your eyes. They can be bought or made and can be fitted to your present prescription spectacles if you wear them. Imagine glasses with side pieces and a surrounding seal.

They do not contain liquid of any kind, as I first thought they must, they are literally to stop your eye from drying out by keeping the area reasonably air tight and because of this they also protect it from small dirt and debris.

Goggles

You may think it ridiculous that I am suggesting that you start to wear swimming goggles but wait until you try to wash your hair.

Goggles, in their right place and time, can be a massive help in certain situations, for example, having a shower, washing your hair and sleeping at night with artificial tears or gel on your eye to keep it moist.

Goggles at night (if you have a dry eye) are better than other options because they do not slip off quite so easily as a patch or tape and act like a moisture chamber whilst you sleep.

Eye patch

This, a little like sunglasses, gives your eye protection from debris, wind and sunlight and also hides your drooping eye from other people’s nosey eyes. I suggest not using a patch whilst you sleep (see below)

Punctal plugs

A punctual plug merely plugs your tear duct to stop all of the tear escaping and thus, it is hoped the tear will remain in the eye and keep it moist. The ones I have seen are tiny compared to this photograph and were not as visible as this, if at all.

Punctal plugs, although scary by name, are a simple silicone device that plug into your tear duct. Your tear gland produces the tears and your tear duct releases your tears away from the eye ready for another coating of tears from the tear gland.

A punctual plug merely plugs your tear duct to stop all of the tear escaping and thus, it is hoped the tear will remain in the eye and keep it moist.

There are different types of these and you should ask your optician or doctor if they think these may help your condition.

The most important thing to take from this EyeCare Series is that you only have one pair of eyes and this is a short period of time in which we need to take great manual care of them.

Do not be afraid of visiting your optician often at first. They are the eye professionals, we are not, but we can learn a great deal from them at each visit.

The opticians that I have seen were all well aware of Bell’s Palsy as a condition to look out for in patients and also as a specialist area with regards the needed manual protection whilst we recover.

Remind yourself how perfectly and delicately they have been designed in the first place – Now for a short while you need to be as perfect and delicate in your manual care of them, whilst you heal.

No matter how you feel on any given day – take care of your eyes.

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