A palpebral spring is an implant that uses a fine spring mechanism to actively help close the eyelids in facial paralysis. It links the upper and lower lids so that residual muscle action or brow movement assists blinking.
Mechanism
The spring is anchored to the tarsal plates or orbital rim and exerts a closing force when activated. Unlike a simple weight, it can provide dynamic closure and opening, aiming for a more natural blink.
- Implant design and placement are tailored to facial anatomy
- Adjustment may be required to balance closure strength and comfort
- Used less commonly than gold weights due to complexity and potential complications
- Usually reserved for selected patients in specialised centres
Considerations
Palpebral springs can improve corneal protection and cosmesis but carry risks of extrusion, infection, and mechanical problems. Careful patient selection and long‑term follow‑up are essential.
- Some patients prefer simpler static procedures or weights
- Device removal is possible if function is inadequate or complications occur
- Artificial tears and protective strategies remain part of care
- Integration with broader facial reanimation plans should be considered
