The ocular surface and meibography in unilateral facial paralysis

Abstract

Clinical relevance: Facial paralysis (FP) often leads to ocular surfacedisorders due to delayed or incomplete blinking. Background: This study aimed to evaluate the ocular surface andmeibomian glands (MG) in patients with unilateral FP. Methods: 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. Results: 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. Conclusion: Facial paralysis impairs ocular surface parameters andincreases lid margin abnormalities. It is associated with higher meiboscoresand deterioration in meibomian gland morphology.