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===Eye Protection===
===Eye Protection===
*Cornea eye protection ([[EBQ:Evidence Levels|Level X]])<ref name="bells guidelines">Baugh RF, Basura GJ, Ishii LE, et al. Clinical practice guideline: Bell's palsy. Otolaryngol Head Neck Surg. 2013;149(3 Suppl):S1-S27. doi:10.1177/0194599813505967</ref>
*Cornea eye protection ([[EBQ:Evidence Levels|Level X]])<ref>Baugh RF, Basura GJ, Ishii LE, et al. Clinical practice guideline: Bell's palsy. Otolaryngol Head Neck Surg. 2013;149(3 Suppl):S1-S27.</ref>
**Artificial tears qhr while patient is awake
**Artificial tears qhr while patient is awake
**Ophthalmic ointment at night
**Ophthalmic ointment at night

Revisión actual - 01:10 21 mar 2026

Eye Protection

  • Cornea eye protection (Level X)[1]
    • Artificial tears qhr while patient is awake
    • Ophthalmic ointment at night
    • Eye should be taped shut at night
    • Protective glasses or goggles

Steroids

Should be started within 72hrs of symptom onset[2]

Antivirals

Most likely no added benefit when combined with steroids.[5] However also little harm associated with antivirals especially in patients with normal renal function[4]

Antibiotics

  • Consider empiric empiric dosing if high index of suspicion for Lyme based on clinical presentation or lab data
  1. Baugh RF, Basura GJ, Ishii LE, et al. Clinical practice guideline: Bell's palsy. Otolaryngol Head Neck Surg. 2013;149(3 Suppl):S1-S27.
  2. Vargish L. For Bell's palsy, start steroids early; no need for an antiviral. J Fam Pract. Jan 2008; 57(1): 22–25http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3183838/pdf/JFP-57-22.pdf
  3. UpToDate. Bell's Palsy Prognosis and Treatment. March, 2014
  4. 4.0 4.1 Gronseth GS, Paduga R. Evidence-based guideline update: Steroids and antivirals for Bell palsy: Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2012Full Text
  5. Lockhart et al. Cochrane Database Syst Rev. 2009 Oct 7;(4):CD001869.