His taste sensation was altered, Bell's phenomenon
was present bilaterally and he was unable to purse his lips or smile (Figure 1).
The Bell's phenomenon
is normal in nine patients, where four are Bimatoprost user (100%), four are Latanoprost users (57.1%) and one patient is Travoprost user (33%).
Bilateral Bell's phenomenon
was positive with drooling of saliva from both angles of mouth without wrinkling on forehead, naso-labial folds on both sides and inability to smile.
The author notes a study describing an 'absent' or 'weak' Bell's phenomenon
in patients with RCEs as compared to controls, and a 78% prevalence of abnormal Bell's phenomenon
in patients without a predisposing condition for their RCE in the same study.
Ptosis examination included: lid fissure height, eyelid crease height, upper lid margin to reflex distance (MRD), scleral show, levator function, lagophthalmos, jaw winking and Bell's phenomenon
(4+ implies complete disappearance of the cornea and zero corresponds to absence of Bell's phenomenon
), inspection for abnormal head posture (e.g.
and corneal sensations were intact.
Physical examination showed left facial weakness with Bell's phenomenon
and left sensorineural hearing loss.
She had a positive Bell's phenomenon
and normal tear break-up time.
However, the response may be the Bell's phenomenon
rather than eye closure.
(9) frontalis sling was not done due to absence of Bell's phenomenon
. Outcomes of different types of surgery were in (Table 2),
Weakness of the orbicularis oculi muscle leads to difficulty in closing the eye and exaggeration of Bell's phenomenon
, the normal upward movement of the eye with lid closure. Early in the clinical course, the patient may complain of pain in the ear or cheek, tinnitus, fever, and either decreased hearing or increased sensitivity to loud noise (hyperacusis).[1,3,11] Other symptoms that may develop include dryness of the eye, drooling, numbness of the face or tongue or both, and alterations in taste on the anterior two thirds of the tongue.[1-3, 11] The symptom complex in individual cases reflects the location of abnormality along the course of the nerve.
All complications of blepharoptosis were noted in form of cosmetic appearance, under correction, lid fold, and bell's phenomenon
, synkinetic movement, lid lag, lagophthalmos, lid notching, entropion, prolapsed of fornix, over correction, exposure keratitis, fat prolapse, sling exposure, granuloma and infection.