Eyelid laceration

Background

  • Must rule-out corneal laceration and globe rupture

Clinical Features

  • History of trauma
  • Visible laceration

Differential Diagnosis

Ocular Diagnoses

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
  • Simple superficial horizontal lacerations may be repaired by the Emergency Physician

Disposition

  • If repaired by the Emergency Physician, discharge with ophtho follow-up
  • All other lacerations require ophtho consult for repair

See Also

References

Authors:

Michael Holtz