A 48-year-old man with a House-Brackmann grade V left facial palsy has poor eye closure, a weak Bell's phenomenon, and fluorescein staining of the inferior cornea. What is the immediate priority in managing the eye?
- A Insertion of a gold weight in the upper lid as the first step
- B Topical antibiotic drops four times daily as definitive therapy
- C Frequent lubricating drops by day, lubricating ointment and taping of the eyelids at night ✓
- D Simple daytime eye patching without any lubricant
Correct answer: C. Frequent lubricating drops by day, lubricating ointment and taping of the eyelids at night
Explanation
With lagophthalmos, weak Bell's phenomenon and established corneal staining, exposure keratopathy threatens vision. The immediate regimen is intensive ocular lubrication with artificial tears during the day plus a viscous ointment and protective taping or a moisture chamber at night; tarsorrhaphy is added if staining progresses. C gold weight improves closure cosmetically but does not protect an already exposed cornea as first-line care, and dry patching without lubrication can worsen epithelial damage.
Reference: Diseases of Ear, Nose and Throat (Dhingra), 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.