Mechanical Injuries 1831 Eyelid Injury

Etiology: Eyelid injuries can occur in practically every facial injury. The following types warrant special mention:

❖ Eyelid lacerations with involvement of the eyelid margin.

❖ Avulsions of the eyelid in the medial canthus with avulsion of the lacrimal canaliculus.

Clinical picture: The highly vascularized and loosely textured tissue of the eyelids causes them to bleed profusely when injured. Hematoma and swelling will be severe (Fig. 18.1). Abrasions usually involve only the superficial layers of the skin, whereas punctures, cuts, and all eyelid avulsions due to blunt trauma (such as a fist) frequently involve all layers. Bite wounds (such as dog bites) are often accompanied by injuries to the lacrimal system.

Treatment: Surgical repair of eyelid injuries, especially lacerations with involvement of the eyelid margin, should be performed with care. The wound should be closed in layers and the edges properly approximated to ensure a smooth margin without tension to avoid later complications, such as cicatricial ectropion (Fig. 18.2).

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