Eyelid laceration: Difference between revisions
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==Background== | ==Background== | ||
*Must rule-out corneal laceration and globe rupture | [[File:Gray896.png|thumb|Anterior view of the right eye, with lacramal duct shown medial.]] | ||
[[File:Gray894.png|thumb|The tarsi and their ligaments. Right eye; anterior view.]] | |||
[[File:eyelid glands.png|thumb]] | |||
*Must rule-out corneal laceration and [[globe rupture]] | |||
==Clinical Features== | ==Clinical Features== | ||
*History of trauma | *History of [[ocular Trauma|trauma]] | ||
*Visible laceration | *Visible laceration | ||
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{{Ocular DDX}} | {{Ocular DDX}} | ||
== | ==Evaluation== | ||
*Clinical diagnosis | *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: | *The following lacerations should be repaired by an oculoplastic specialist: | ||
**Lid margin | **Lid margin | ||
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**Wounds associated with ptosis | **Wounds associated with ptosis | ||
**Tarsal plate or levator palpebrae muscle involvement | **Tarsal plate or levator palpebrae muscle involvement | ||
*Simple superficial horizontal lacerations may be repaired by the Emergency Physician | *Simple superficial horizontal lacerations may be repaired by the Emergency Physician | ||
*Sutures should be removed | **Anesthesia: [[Nerve Block: supraorbital|supraorbital block]] or [[Nerve Block: Infraorbital|infraorbital block]]. | ||
*[[ | **6-0 or 7-0 [[Sutures|suture]] recommended | ||
**Sutures should be removed in 5-7 days | |||
*[[Tetanus prophylaxis]] | |||
==Disposition== | ==Disposition== | ||
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==See Also== | ==See Also== | ||
*[[ | *[[Laceration repair]] | ||
{{Special lacerations see also}} | |||
==External Links== | |||
==References== | ==References== | ||
<References/> | <References/> | ||
[[Category: | [[Category:Ophthalmology]] | ||
[[Category:Trauma]] | [[Category:Trauma]] | ||
Latest revision as of 21:33, 23 October 2024
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
See Also
Special Lacerations by Body Part
- Head
- Hand
- Other
- Bites
- General laceration repair (main)