Lids and Lashes (pt 9)

Potential Dx for “I had trauma to my eyelid”

• Eyelid lacerations

• Thermal burns

Trauma

Typically occurs with young males and elderly adults

Usually caused by sports or motor vehicle events

Eyelid lacerations

Partial or full thickness cut of lid from a sharp object

Superficial, marginal, canalicular

Things performed during exam for lacerations

• Determine how injury occurred

• If globe is open or closed

• Dilation and irrigation for canalicular lacerations

• Wound cleaning

Superficial laceration

Runs parallel to lid margin

May or may not scar

Tx: Suture

Marginal laceration

Involves lid margin

Scarring and notching of lid margin

Tx: Suture

Canalicular laceration

Involves canaliculus

Scarring and epiphora

Tx: Suture and tube shunt insertion

Additional eyelid lacerations Tx

• Tetanus shot depending on cause

• Systemic antibiotics if foreign body or dog bite

• Rabies shot for dog bites

• Topical antibiotics

Thermal burns

Injuries to tissue around eyes from extreme heat

Injury causes release of inflammatory mediators that result in vasodilation, pain, and edema

1st, 2nd, 3rd

1st degree burn

Only epidermis effected

No blister or scar

Clinical findings: Skin hyperemia with pain

2nd degree burn

Affect epidermis and dermis

Some blistering and scarring

Clinical findings: Skin hyperemia with red moist/pale white blister base

3rd degree burn

Affect epidermis, dermis, and all regenerative elements

Blistering and scarring

Clinical findings: Painless, dry leathery skin

Thermal burn complications

Abnormalities in tear production, lashes, lid position, cornea

Depends on severity and location

Thermal burns Tx

• Cool compress to stop heat from penetrating deeper

• Clean debris and gauze

• Topical antibiotic ointment (prevent secondary infection)

• Oral pain medication (3rd degree)