Abstract

Lower lid retraction and paralytic ectropion secondary to facial nerve palsy lead to lagophthalmos and exposure keratopathy. There are many procedures like tarsorrhaphy, canthal tightening, and sub-orbicularis oculi fat elevation in our armamentarium to address the lower lid retraction. The procedure of choice is case-based. The use of spacer graft is popular in lower lid retraction due to thyroid eye disease. The sclera, autogenous tarsus, and hard palate graft have been mainly used as spacer grafts. Autogenous tarsus transplant has an edge over other grafts in facial nerve palsy as it addresses the upper eyelid retraction simultaneously in these cases. We demonstrate the procedure of autogenous tarsus graft transplant in lower eyelid retraction in facial nerve palsy.