Eyelid laceration: Difference between revisions
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==Background== | ==Background== | ||
[[File:Gray896.png|thumb|Anterior view of the right eye, with lacramal duct shown medial.]] | |||
[[File:eyelid glands.png|thumb]] | [[File:eyelid glands.png|thumb]] | ||
*Must rule-out corneal laceration and [[globe rupture]] | *Must rule-out corneal laceration and [[globe rupture]] | ||
Revision as of 19:30, 26 October 2021
Background
- Must rule-out corneal laceration and globe rupture
Clinical Features
- History of trauma
- Visible laceration
Differential Diagnosis
Ocular Diagnoses
- Acute angle-closure glaucoma
- Conjunctival abrasion
- Corneal foreign body
- Corneal ulcer
- Episcleritis
- Painful eyes with normal exam
- Pterygium
- Scleritis
- Traumatic hyphema
- Uveitis
- Pinguecula
Evaluation
- Clinical diagnosis
- Consider orbital XR or CT to evaluate for foreign body, fractures, etc
- Check tetanus status
Management
- The following lacerations should be repaired by an oculoplastic specialist:
- Lid margin
- Only if >1mm; <1mm does not require suturing and will heal spontaneously
- Within 6-8mm of medial canthus
- Lacrimal duct or sac involvement
- Inner surface of the lid involvement (or "through and through" laceration)
- Wounds associated with ptosis
- Tarsal plate or levator palpebrae muscle involvement
- Lid margin
- Simple superficial horizontal lacerations may be repaired by the Emergency Physician
- Anesthesia: supraorbital block or infraorbital block.
- 6-0 or 7-0 suture recommended
- Sutures should be removed in 5-7 days
- Tetanus prophylaxis
Disposition
- If repaired by the Emergency Physician, discharge with ophtho follow-up
- All other lacerations require ophtho consult for repair