As some of you know, I am facial PT in Pittsburgh (yeah, please don't hold it against me that we have 2 world champions at the same time
) Thought it might be useful to share a basic eye exercise that can often get the eyelids strong enough to do their job again (and avoid surgery). You may know that when the eye rolls up during closure, it's called a bells phenomenon. It's a protective reflex that occurs when the eyelids themselves are too weak to fully close. It's a good thing, but may outlive its need, and keep going anyway due to habituation (once a brain, or neural, pattern is established it tends to stay that way). Here's the thing, when the eye rolls up, the lights go out, and you and more importantly, unconsciously, the brain thinks the eye is closed. So there is no more motivation for the brain to send signals to the eyelids (orbicularis oculi superiorus and inferiorus) to keep working. So they don't work any harder.... and they never get stronger for this reason. As long as your eyeball rolls up, the eyelids don't need to get stronger and they often stay "lazy".
Now one important caveat: sometimes there really isn't enough nerve fibers regenerated to the eyelids, in which case the following exercise will not work. However, my years of experience have taught me that this caveat problem is less common that you think.
Here is the exercise: sit straight, look down at your hand in your lap (or on table), close your eyes as far as you can without losing sight of your hand (and allow the good eye to close all the way). This should result in your weak eyelids closing partially - the goal is a slit that you can still see your hand through. This may not happen immediately, it may take some practice. You may feel some initial eye strain. Don't push it hard. After a number of reps, it should start to get easier. If you lose sight of you hand, it is because your eye rolled up, not because you eye fully closed... so it is critical to this exercise that you do not lose sight of your hand at the beginning. Hold there for 5 count, then either try to close all the way while still looking down, or use a finger to finish the close (you need someone to tell you if it rolled up or closed fully if you try the former). Once shut, take finger way slowly while still looking downward and squeezing the eyelids shut a little (not a lot to keep cheeks out of it), then hold 5 or 10 more count. Reopen, relax. I give this, or a variation, to almost every pt. I treat with eyeclose (during day) problems. Usually 10 reps 2 or 3 times a day.
Hope this is of use. Obviously, I'd suggest doing under supervision of a therapist, but knowlege is power, right! In my years (since 1992) I've never had anyone harmed by this exercise. Understand that this is only a suggestion and an option, and I take no responsibility for success or failure. Any questions?
