Corneal status improves as facial paralysis progresses to synkinesis

A retrospective cohort study examined 180 corneal examinations in 40 patients with facial synkinesis evaluated by ophthalmology between 2009 and 2025. Punctate epithelial erosion scores were highest during acute paralysis and improved significantly during synkinesis development, plateau, and long-term follow-up, while scleral show decreased and complete forceful eye closure increased from 30% to 100% over time. The authors conclude that synkinesis may provide corneal protection, suggesting surgical intervention may be avoided in many patients.

Most relevant for: Patients transitioning from acute facial paralysis to synkinesis who are being monitored for corneal exposure and considered for surgical intervention.

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