Eyelid Injury
Eyelid injuries can occur in practically every
facial injury. The fol-lowing 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.
The highly vascularized and loosely textured
tissue of theeyelids causes them to bleed profusely when injured. Hematoma and
swell-ing will be severe (Fig. 18.1).
Abrasions usually involve only the
superficial lay-ers of the skin, whereas punctures,
cuts, and all eyelid avulsions due to blunttrauma (such as a fist) frequently involve all
layers. Bite wounds (such as dogbites) are often accompanied by injuries to the
lacrimal system.
Surgical repair of eyelid injuries, especially
lacerations withinvolvement 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
cicatri-cial ectropion (Fig. 18.2).
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