{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T16:16:49Z","timestamp":1783700209584,"version":"3.55.0"},"reference-count":10,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Rep Ophthalmol"],"abstract":"<jats:p>Introduction: Facial nerve palsy (FNP) with associated ptosis and keratoconus (KC) presents a combined challenge of visual dysfunction, ocular-surface disease, and cosmetic impairment. While surgical procedures are frequently performed, scleral contact lenses can offer both ocular-surface protection and mechanical eyelid support. While scleral lenses have previously been described for exposure keratopathy and irregular corneal astigmatism, the present 2-case series provides objective margin reflex distance-1 (MRD1) documentation of eyelid elevation achieved through quadrant-asymmetric scleral contact lens (QASCL) fitting in elderly patients with concurrent FNP and KC requiring simultaneous KC rehabilitation \u2013 an outcome combination not previously reported in this population. Case Presentation: Two elderly patients with KC and FNP were fitted with QASCL after poor tolerance of soft lenses. A 71-year-old man with severe lagophthalmos and brow ptosis showed MRD1 improvement from 1.0 mm to 3.5 mm and best-corrected visual acuity (BCVA) from 1.3 logMAR to 0.1 logMAR. His Ocular Surface Disease Index (OSDI) score decreased from 79.16 to 33.33 after 3 months, and the Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8) score was 11. A 74-year-old man with mild synkinesis had MRD1 increase from 0.5 mm to 3.0 mm and BCVA from 1.0 logMAR to 0.02 logMAR. His OSDI decreased from 91.66 to 45.83 after 3 months, and CLDEQ-8 was 16. Both patients exhibited reduced ocular-surface staining, improved meibomian gland function, and decreased conjunctival hyperemia over follow-up. Conclusion: QASCL fitting was associated with clinically meaningful improvements in eyelid elevation, visual acuity, and ocular-surface integrity, together with reductions in symptom severity as measured by OSDI and CLDEQ-8. In these two elderly patients with FNP and KC, QASCLs appeared safe, effective, and reversible nonsurgical option, providing sustained functional and anatomical benefit during long-term follow-up.<\/jats:p>","DOI":"10.1159\/000552540","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T16:01:20Z","timestamp":1779379280000},"page":"661-673","source":"Crossref","is-referenced-by-count":0,"title":["Eyelid Elevation and Ocular Surface Rehabilitation Using Quadrant-Asymmetric Scleral Contact Lenses in Facial Nerve Palsy with Keratoconus: A 2-Case Series"],"prefix":"10.1159","volume":"17","author":[{"given":"Nir","family":"Erdinest","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zvi","family":"Gur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Tabi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noam","family":"Blum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadav","family":"Shemesh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Yahalom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Itay","family":"Lavy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,5,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1007\/s11910-010-0143-1"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1177\/0194599813505967"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000006020"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1159\/000512505"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.118.5.615"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1097\/OPX.0b013e318269c90d"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1097\/ICL.0000000000000748"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.2147\/OPTO.S144357"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.51329\/mehdiophthal1525"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2016.1462"}],"container-title":["Case Reports in Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000552540","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T16:01:18Z","timestamp":1783699278000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000552540"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,21]]},"references-count":10,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000552540","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.32333883","asserted-by":"subject"}]},"ISSN":["1663-2699"],"issn-type":[{"value":"1663-2699","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,21]]}}}