Review of OptometryCut Out for Cuts

Numerous types of facial injuries can result in eyelid lacerations, which typically call for immediate attention.

A complex case of a 48-year-old male who sustained a significant eyelid laceration in a motor vehicle accident provides valuable insights into the diagnosis, treatment, and follow-up of such injuries.

Key Points:

• The patient presented with a full-thickness tear of the left lower eyelid, involving the inferior canaliculus, following a motor vehicle accident.
• The patient’s visual acuity was 20/50 OD and 20/30 OS, with pupils equally round and reactive in both eyes.
• The patient was diagnosed with a canaliculus-involving marginal laceration of the left lower lid and underwent emergent repair in the minor operating room.

Additional Points:

• Eyelid lacerations can be caused by various forms of facial trauma and are often associated with other ocular injuries.
• A methodical approach to evaluating an eyelid laceration includes obtaining a detailed history, performing a CT scan or MRI, and wound irrigation.
• Eyelid lacerations can be classified into three groups: without eyelid margin involvement, with eyelid margin involvement, or with nasolacrimal system involvement.
• Surgical repair options include direct laceration closure via sutures, canthal release, transitional flap, grafts, and lacrimal stents.
• The patient was placed on amoxicillin-clavulanate and bacitracin zinc/polymyxin B ointment postoperatively.

Conclusion:

• The patient’s recovery was successful, with decreased edema and improved ecchymosis observed 18 days post-injury. The lacrimal system and periorbital skin continue to be monitored for drainage, epiphora, and hyperpigmented scarring.

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Did You Know?
Eyelid lacerations are most common in the pediatric population, often due to bike handlebar accidents, collisions with sharp objects, dog bites, and falls.