The Ophthalmology Unit,  Universiti Malaysia Sarawak (UNIMAS), Kuching, Sarawak.
	The Ophthalmology Department, Sarawak General Hospital, Kuching, Sarawak, East Malaysia.

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Facial nerve palsy with eyelid retraction

Photo by Professor Chua Chung Nen

This 63 year-old had been suffering from an uncomfortable left eye following acoustic neuroma excision 5 years ago. He had good Bell's phenomenon and the discomfort was due to conjunctival exposure as a result of poor lid closure. He had a lateral tarsorrhaphy performed 3 years. We performed a medial canthoplasty which reduced the exposure but the discomfort remained significant. He was advised to have either an upper lid gold weight implantation or mullectomy to improve the upper eyelid closure. He favored the later and mullectomy was performed via a posterior approach. Post-operatively, the ocular discomfort was much improved.

Conjunctival expsoure before surgery. Note previous medial canthoplasty and

lateral tarsorrhaphy.

Reduced exposure one week after mullectomy.

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