lacerations near the eye

Lacerations near the Eye

Priorities

Was the globe penetrated? Is there a foreign body? Was the orbit penetrated? Is there a globule of fat

sticking out of a lid laceration? If so there may be a globe injury without posterior lid penetration.

Is there a vertical lid laceration, that if repaired may lead to a contracture, inability to close lids and chronic corneal ulcers?

Priorities

Is there a through and through laceration involving tarsal plate? Is there loss of more than 1/3 of lid margin?

Are important structures in lids involved?

When debriding eyebrow wound, angle cuts parallel to hair roots and follicles

Levator palpebrae muscle and lateral and medial ligaments must be intact for eye to close properly

Horizontal lid lacs, determine no orbit penetration, Levator intact, close with simple interrupteds

Most lid margin lacerations best consulted to eye or plastics, but

1st tarsal suture brought out superiorly at gray line

Consult, but if you must: