Facial nerve palsy is a commonly encountered problem in ophthalmology practice. The severity of symptoms affecting the eye can vary significantly. Some patients will require only treatment with occasional artificial tears, whereas others will require multiple surgeries to address chronic corneal exposure.
When assessing a patient with facial nerve palsy, the clinician should consider the underlying etiology. A patient who has undergone a parotidectomy with transection of the facial nerve will require more rehabilitation than a patient with idiopathic Bell's palsy, who will most likely recover full function. The House-Brackman grading system (Table 1) can be helpful in communicating the severity of facial nerve palsy to other physicians and to follow the course of an individual patient.