The facial nerve controls the muscles of facial expression, including the frontalis muscle (raises the eyebrows), the orbicularis oculi muscle (closes the eyes), the zygomaticus muscles (raises the angle of the mouth), and the orbicularis oris muscle (closes the mouth). With paralysis or palsy of the nerve, the function of these muscles are weakened.

One may be born with a facial palsy, or it may develop later. Acquired causes include infection (Bell's Palsy), blood vessel problems, tumors or injuries.Eye problems include eyebrow drooping, elevation of the upper eyelid, ptosis and ectropion of the lower eyelid, excessive watering, inability to close the eye drying of the cornea.

The aims of treatment are to protect the eye, improving cosmesis, and if present treat any watering . Many patients can be managed medically with topical lubrication drops and ointment, moisture chambers, and taping the eyelids closed at bedtime to protect the eye. In severe cases or longstanding ones, it may be possible or mandatory to treat some problems with operations.

If the eye sight is threatened, it may be necessary to do surgery to help protect the eye. A variety of procedures is available, and which one is most suitable, must be individualised and depends on the stage of recovery and the amount of palsy at the time. If the palsy does not heal properly, several options are open for rehabilitation: both function of the eye, as well as cosmesis need to be considered. It is quite clear that seventh nerve palsy can cause significant cosmetic deformities, that can often be addressed very satisfactorily. Nobody though can make the abnormalities disappear completely.