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Eyelid laceration
From WikEM
Contents
Background
- Must rule-out corneal laceration and globe rupture
Clinical Features
- History of trauma
- Visible laceration
Differential Diagnosis
- Acute angle-closure glaucoma
- Conjunctival abrasion
- Corneal foreign body
- Corneal ulcer
- Episcleritis
- Painful eyes with normal exam
- Pterygium
- Scleritis
- Traumatic hyphema
- Uveitis
Evaluation
- Clinical diagnosis
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
Disposition
- If repaired by the Emergency Physician, discharge with ophtho follow-up
- All other lacerations require ophtho consult for repair
