General Medical Information

Eyelid Laceration

Jean Edwards Holt

Trauma to the eyelid can be routine or quite involved. A superficial laceration, parallel to the lid margin, is similar to a skin laceration in other parts of the body and can be repaired in the same manner. Foreign bodies, however, can be overlooked; therefore the wound should be explored and irrigated well before surgical closure. If the deeper structures are involved, the anatomic relations of the levator palpebral muscle, tarsal plates, and orbital septum must be known and the appropriate repairs performed. Lacerations that involve the lid margin or are medial to the punctum and involve the canalicular structures necessitate detailed surgical reconstruction. The primary repair is extremely important because secondary scar revision and attempts to reestablish the function of the eyelid and tear drainage apparatus are difficult. Faulty repair can produce a notch in the eyelid that interferes with its ability to spread the tear film. Irritation and constant tearing can be caused by loss of corneal epithelium and perhaps cause ulceration of the cornea. Involved lacerations therefore should be managed by a surgeon knowledgeable in the anatomic and physiologic characteristics of the eyelids.