Eyelid Laceration

Updated: Aug 20, 2015
  • Author: Edsel Ing, MD, FRCSC; Chief Editor: Hampton Roy, Sr, MD  more...
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Overview

Practice Essentials

In all patients with eyelid injuries, exclude underlying globe injury and/or canalicular laceration.

During surgical repair of lid lacerations, ensure that no knots or suture material can damage the cornea.

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Background

Numerous mechanisms of blunt and penetrating facial trauma may result in eyelid lacerations. Even seemingly innocuous blunt objects in the workplace can cause eyelid lacerations in experienced workers.

Penetrating lid trauma with extensive periorbital Penetrating lid trauma with extensive periorbital ecchymosis. A ringlike projectile was ejected from a pipe fitting under high pressure. The patient also experienced choroidal rupture and traumatic optic neuropathy.

Eyelid lacerations may (1) involve the lid margin, requiring a meticulous suture technique; (2) be extramarginal; or (3) cause tissue loss.

Extramarginal upper lid laceration from blunt trau Extramarginal upper lid laceration from blunt trauma in an infant. Such lacerations tend to follow relaxed skin tension lines.

Proper management includes the following:

  • Excluding any accompanying injury to the globe
  • Protecting the cornea and maintaining proper lid dynamics
  • Excluding a foreign body
  • Minimizing the risk of infection
  • Optimizing cosmesis
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Epidemiology

Age

Eyelid lacerations are most frequently encountered in young men, but can occur at any age and have even been described in newborns after cesarean delivery. [1]

Location

In a study from Iran, the right upper lid was the most frequently involved site of injury. [2]

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Prognosis

The visual prognosis for lid lacerations is usually excellent unless there is accompanying globe rupture.

With proper reconstruction of lid lacerations, the cosmetic result is usually quite good. Lid notching, cutaneous scars, and cicatricial ectropion may require revision surgery.

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