Due to the lack of corneal protection the eye dries out with formation of ulcerations and vision changes. Conservative measures include taping the eye closed at night and the use of lubricants. B. A tarsorrhaphy may be required for adequate protection. The eyelid margins are denuded and sutured together until scarring occurs. C. A gold weight can be placed into the upper eyelid for a more dynamic procedure.
Weights tend to work best with lid paresis.
An implant of appropriate weight is selected to allow lid closure secondary to gravity. D. Spring like devices can be implanted in the lid. These work better with total lid paralysis. May uses 0.3mm orthodontic wire to fashion the springs. Each is shaped for the individual.