How to Tape Your Eye Shut for Ramsay Hunt Syndrome

Paralytic lagophthalmos—the medical term for being unable to fully close your eye due to facial nerve palsy—is a common complication of Ramsay Hunt syndrome ^[1][2]. Because your eyelid cannot blink or seal shut on its own, taping your eye closed at night, combined with lubricating ointments, is a critical physical barrier to help reduce the risk of severe dryness, corneal scratching, and dangerous conditions like neurotrophic keratitis ^[3][4].

⚠️ Urgent Warning

Seek same-day or urgent eye assessment if you experience new or worsening eye pain, redness, light sensitivity, discharge, a gritty/foreign-body sensation, blurred vision, or an inability to keep the eye fully closed ^[3][5]. Seek emergency care for sudden vision loss or severe pain. Do not wait for symptoms to worsen or rely only on taping while waiting for assessment. Note: Facial palsy can cause reduced corneal sensation (neurotrophic keratitis), which means serious eye damage can occur without you feeling any pain.

Why Eye Protection Matters

When your eyelid remains open while you sleep, your cornea (the clear front surface of the eye) is exposed to the air. This exposure keratopathy (drying and damage to the cornea) can quickly lead to dehydration, thinning, and scarring ^[3]. The lack of a normal blink reflex can also disrupt tear distribution, contributing to severe dry-eye disease ^[6]. If left unprotected, this continuous exposure can cause painful corneal ulcers (open sores on the eye), infections, and vision loss ^[7][8]. While consistent protection reduces these risks, it does not guarantee prevention, and recovery time varies.

Daytime Eye Care

Nighttime taping is only part of the solution. During the day, you should use clinician-directed, preservative-free lubricating drops frequently, wear sunglasses or moisture chambers to protect the eye from wind, dust, and fans, and avoid rubbing your eye ^[4][9].

Step-by-Step Eye Taping Guide

Note: Your eye care team must demonstrate this technique for you to ensure you are doing it safely based on your specific eye shape and skin sensitivity.

1. Clean and prepare: Thoroughly wash and dry your hands. Ensure the skin around your eye is clean and dry. Gather gentle, hypoallergenic medical paper tape and your prescribed or preservative-free ophthalmic lubricating ointment ^[10].

2. Apply lubricating ointment: Right before going to sleep, place a ribbon of the ointment inside your lower eyelid, as directed by your doctor. Do not let the tip of the tube touch your eye or eyelashes. Keep ointment off the surrounding skin where tape needs to adhere. Note: Ointment will temporarily blur your vision, which is normal ^[10][9].

3. Manually close the eyelid: Gently press your upper eyelid down with your washed fingers until it completely meets the lower lid. (While some patients use the back of a clean spoon if fingers are too bulky, this risks slipping and transferring contamination or pressing on the eye. Washed hands are much safer. Never press directly on your eyeball.)

4. Apply the tape:

• Cut a piece of medical paper tape to the size recommended by your doctor.
• While holding the eyelid gently but fully closed (without traction or pressure), begin taping horizontally or diagonally with a gentle medical paper tape to ensure the eyelid stays fully closed ^[4].
• Use the specific placement demonstrated by your clinician to ensure it anchors the lid securely to the cheek without pulling on the brow or leaving gaps.

5. Check the seal and safety: Ensure the lid is completely closed.
Crucial Warning: The tape must sit entirely on the outside of your eyelids and skin. Never let the sticky side of the tape touch your actual eye (the cornea), as this can cause immediate, severe scratching and damage ^[3][5]. Stop and contact your clinician if you experience pain, pressure, skin blistering, or an allergic reaction to the adhesive.

6. Safe removal: In the morning, gently peel the tape off. Do not pull forcefully on the eyelashes or eyelid skin. If it is stuck firmly, dab it with a little warm water to loosen the adhesive before pulling.

Alternatives to Taping

Some people with facial nerve palsy find that medical tape irritates their skin or doesn’t keep their eye fully closed ^[10][11]. Do not improvise if taping fails; discuss these alternatives with your doctor:

• Moisture chamber goggles: These are specialized, clinician-fitted enclosed goggles you wear at night. They create a humid, sealed environment around your eye, protecting the cornea without the need for adhesive tape ^[12][3].
• External eyelid weights: These are temporary weights matched to your skin tone and fitted by a specialist, taped to the outside of your upper eyelid to help gravity pull the lid down ^[13].
• Surgical options: If your lagophthalmos is persistent, an ophthalmologist might discuss procedures like a temporary tarsorrhaphy (partially sewing the eyelids together) or surgically implanting a small gold or platinum weight into the eyelid to ensure it closes completely ^[8][14].