II. Exam: Findings suggestive serious Eye Injury (indications for urgent or emergent ophthalmology referral)
- See Globe Rupture
- Lacrimal duct injury (or injury in vicinity medial canthus)
- Retrobulbar fat Herniating from periorbital Laceration
- Associated with orbital septum penetration
-
Ptosis
- Associated with levator palpebrae injury or tarsal plate injury
-
Eyelid margin injury
- Requires close approximation to prevent extropion, Entropion and poor cosmetic result
- Full thickness or inner lid Laceration
- Best closed by ophthalmology
- Inadequate Corneal coverage
- Eyelid Laceration that results in incomplete closure over Cornea is a risk for Corneal Injury
III. Management: General
- Globe may be perforated
- Cleanse wound only if certain that globe is intact without rupture
-
Eye Protection if delayed closure (e.g. transfer to ophthalmology for repair)
- Antibiotic ointment and artificial tears
- Moist dressing
IV. Management: Laceration Repair
- Refer to ophthalmology for closure if concern for globe injury, lacrimal duct injury or other serious structural injury
- Indications
- Small superficial, non-marginal wounds (lateral to the lacrimal duct, lacrimal caruncle and papilla)
- Non-full-thickness Eyelid Lacerations
- Technique (using 6-0 Nylon Suture)
- Avoid Tissue Adhesive if possible (risk of Cyanoacrylate Eye Injury and increased risk of Periorbital Cellulitis)
- Consider morgan lens to shield the eye prior to Local Anesthetic injection and suturing
- Apply tetracaine topically to eye prior to morgan lens insertion
- Consider leaving Sutures long to allow for retraction of the lid from the globe surface
- While injecting Anesthesia and suturing, manually retract the Eyelids up or down, off the globe surface
V. Complications
- Damage to lacrimal drainage system (medial canthus Laceration)
- Eyelid notching (Eyelid margin involved)
- Damage to levator palpebrae Muscle or tarsal plate
VI. References
- Lin and Lin in Herbert (2014) EM:Rap 14(11): 8-10
Images: Related links to external sites (from Bing)
Related Studies
| Concepts | Injury or Poisoning (T037) |
| SnomedCT | 157353007, 231816006 |
| English | laceration of eyelid (diagnosis), laceration of eyelid, Laceration of eyelid (disorder), laceration of eyelid (physical finding), of eyelid laceration, eyelid laceration, Laceration of eyelid, eyelid; laceration, laceration; eyelid |
| Spanish | Laceración de párpado, laceración del párpado, laceración palpebral (trastorno), laceración palpebral |
| Portuguese | Laceração da pálpebra |
| Italian | Lacerazione della palpebra |
| German | Hauteinriss am Augenlid |
| French | Lacération de la paupière |
| Dutch | inscheuring van ooglid, laceratie; ooglid, ooglid; laceratie |
| Czech | Lacerace očního víčka |
| Japanese | ｶﾞﾝｹﾝﾚｯｼｮｳ, 眼瞼裂傷 |
| Hungarian | Szemhéj szakított sebe |
