Conjunctival laceration - Revision history

Danbot: Expand with concise EM-focused content: Seidel test importance, simple vs complex management, open globe rule-out

2026-03-21T01:24:45Z

Expand with concise EM-focused content: Seidel test importance, simple vs complex management, open globe rule-out

← Older revision		Revision as of 01:24, 21 March 2026
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	==Background==		==Background==
	*~~From~~ penetrating [[ocular ~~Trauma~~\|injury]] ~~to the ocular surface~~		*Tear or disruption of the conjunctival membrane from penetrating or blunt [[ocular trauma\|eye injury]]
			*Conjunctivae have less innervation than cornea → often less painful than corneal injuries
			*'''Critical concern:''' Must rule out underlying scleral laceration or [[open globe injury\|open globe]] — conjunctival lacerations can mask scleral perforation

	==Clinical Features==		==Clinical Features==
	*Conjunctivae have less innervation than cornea so far less symptomatic		*Full-thickness defect visible in the conjunctiva
	*Full-thickness defect in the conjunctiva		*[[Red eye\|Chemosis]], subconjunctival hemorrhage
	*[[Red eye\|Chemosis]]		*Mild-to-moderate discomfort (less than corneal injuries)
			*May have associated conjunctival foreign body

	==Differential Diagnosis==		==Differential Diagnosis==
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	==Evaluation==		==Evaluation==
	*[[~~Eye Exam~~]]		*Complete [[eye exam]] including visual acuity
	**Confirm negative seidel'~~s sign~~ (~~rule out~~ globe ~~rupture~~) ~~and no~~ traumatic hyphema		*'''Seidel test:''' Apply fluorescein — look for streaming of aqueous (positive = globe perforation)
	*CT orbit		*Evert eyelids to look for foreign bodies
			*Assess for [[hyphema\|traumatic hyphema]], pupil irregularity, or decreased IOP (signs of open globe)
			*CT orbit if high-energy mechanism, concern for intraorbital foreign body, or orbital fracture

	==Management==		==Management==
	===Simple===		===Simple (all of the following)===
	*~~All of the following:~~		*Superficial laceration
	**Superficial		*<1 cm in length
	**Not associated with any other serious intraorbital or ocular injury		*No other serious intraorbital or ocular injury
	**Small (<1 cm)		*Negative Seidel test
	*[[Erythromycin]] ophthalmic ointment ~~and ophtho referral~~		*'''Treatment:''' [[Erythromycin]] ophthalmic ointment QID × 5-7 days, ophthalmology follow-up

	===Complex===		===Complex===
	*Discuss with ophthalmology		*>1 cm, deep, or associated with other ocular injuries
			*Positive Seidel test → treat as [[open globe injury\|open globe]] (shield eye, NPO, emergent ophthalmology)
			*Discuss with ophthalmology — may require surgical repair

	==Disposition==		==Disposition==
	*Simple: ~~Outpatient~~		*Simple: discharge with erythromycin ointment, ophthalmology follow-up in 1-2 days
	*Complex: ~~Discuss with ophtho~~		*Complex: ophthalmology consult in ED; admit if open globe or requires surgical repair

	==See Also==		==See Also==
	*[[Eye Algorithms (Main)]]		*[[Eye Algorithms (Main)]]
			*[[Open globe injury]]
			*[[Corneal abrasion]]
	{{Special lacerations see also}}		{{Special lacerations see also}}

	~~==External Links==~~

	==References==		==References==

Rossdonaldson1: /* See Also */

2023-03-01T19:20:44Z

ClaireLewis at 16:24, 5 October 2019

2019-10-05T16:24:20Z

← Older revision		Revision as of 16:24, 5 October 2019
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	==Background==		==Background==
	*From penetrating [[ocular ~~injury~~\|injury]] to the ocular surface		*From penetrating [[ocular Trauma\|injury]] to the ocular surface

	==Clinical Features==		==Clinical Features==

ClaireLewis at 16:24, 5 October 2019

2019-10-05T16:24:09Z

← Older revision		Revision as of 16:24, 5 October 2019
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	==Background==		==Background==
	*From penetrating injury to the ocular surface		*From penetrating [[ocular injury\|injury]] to the ocular surface

	==Clinical Features==		==Clinical Features==
	*~~full~~-thickness defect in the conjunctiva		*Conjunctivae have less innervation than cornea so far less symptomatic
	*~~chemosis~~		*Full-thickness defect in the conjunctiva
			*[[Red eye\|Chemosis]]

	==Differential Diagnosis==		==Differential Diagnosis==
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	==Evaluation==		==Evaluation==
	*[[Eye Exam]]		*[[Eye Exam]]
	**~~confirm~~ negative ~~sidel~~'s sign (rule out globe rupture) and no traumatic hyphema		**Confirm negative seidel's sign (rule out globe rupture) and no traumatic hyphema
	*CT orbit		*CT orbit

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	**Not associated with any other serious intraorbital or ocular injury		**Not associated with any other serious intraorbital or ocular injury
	**Small (<1 cm)		**Small (<1 cm)
	*Erythromycin ophthalmic ointment and ophtho ~~referal in 1-3~~		*[[Erythromycin]] ophthalmic ointment and ophtho referral

	===Complex===		===Complex===
	*Discuss with ~~ophthomology~~		*Discuss with ophthalmology

	==Disposition==		==Disposition==

Rossdonaldson1: Text replacement - "r/o" to "rule out"

2016-07-30T15:31:45Z

Text replacement - "r/o" to "rule out"

← Older revision		Revision as of 15:31, 30 July 2016
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	==Evaluation==		==Evaluation==
	*[[Eye Exam]]		*[[Eye Exam]]
	**confirm negative sidel's sign (~~r/o~~ globe rupture) and no traumatic hyphema		**confirm negative sidel's sign (rule out globe rupture) and no traumatic hyphema
	*CT orbit		*CT orbit

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-22T20:34:13Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 20:34, 22 July 2016
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	{{Unilateral red eye DDX}}		{{Unilateral red eye DDX}}

	==~~Diagnosis~~==		==Evaluation==
	*[[Eye Exam]]		*[[Eye Exam]]
	**confirm negative sidel's sign (r/o globe rupture) and no traumatic hyphema		**confirm negative sidel's sign (r/o globe rupture) and no traumatic hyphema

Neil.m.young: Text replacement - "==Sources==" to "==References=="

2016-06-26T10:45:19Z

Text replacement - "==Sources==" to "==References=="

← Older revision		Revision as of 10:45, 26 June 2016
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	==External Links==		==External Links==

	==~~Sources~~==		==References==
	<references/>		<references/>

	[[Category:Ophthalmology]]		[[Category:Ophthalmology]]

Ostermayer: Text replacement - "Category:Ophtho" to "Category:Ophthalmology"

2016-03-22T15:43:10Z

Text replacement - "Category:Ophtho" to "Category:Ophthalmology"

← Older revision		Revision as of 15:43, 22 March 2016
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	<references/>		<references/>

	[[Category:~~Ophtho~~]]		[[Category:Ophthalmology]]

Rossdonaldson1: /* Disposition */

2015-05-24T13:43:43Z

Disposition

← Older revision		Revision as of 13:43, 24 May 2015
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	==Disposition==		==Disposition==
			*Simple: Outpatient
			*Complex: Discuss with ophtho

	==See Also==		==See Also==

Rossdonaldson1: /* Workup */

2015-05-24T13:42:51Z

Workup

← Older revision		Revision as of 13:42, 24 May 2015
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	{{Unilateral red eye DDX}}		{{Unilateral red eye DDX}}

	==~~Workup~~==		==Diagnosis==
	*[[Eye Exam]]		*[[Eye Exam]]
	**confirm negative sidel's sign (r/o globe rupture) and no traumatic hyphema		**confirm negative sidel's sign (r/o globe rupture) and no traumatic hyphema

← Older revision		Revision as of 19:20, 1 March 2023
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	==See Also==		==See Also==
	*[[Eye Algorithms (Main)]]		*[[Eye Algorithms (Main)]]

			{{Special lacerations see also}}

	==External Links==		==External Links==