Lid Laceration

  • Traumatic slicing of lid
  • Usually caused by trauma from sharp objects, but blunt objects can cause it too
  • Prompt and skilled surgical repair is critical to protect eye, maintain good tear flow, restore cosmetic appearance
  • Affected lids appear torn and displaced
  • Hemorrhage and swelling may conceal site and extent of wound
  • Complicated lacerations may extend through lid margin, displace tissue, or involve tear drainage system in lower lid
  • Nothing—challenge is to find laceration in swollen and distorted lids
  • Leave small lacerations remote from lid margins alone to heal on their own
  • Let ophthalmologists repair large, deep lacerations and those that involve lid margin or lacrimal drainage system
  • Suture other lacerations with 6-0 interrupted sutures (nonabsorbable in adults, absorbable in children)
  • Inadequately repaired large lacerations or lid-margin lacerations leave poor appearance and may lead to poor lid closure
  • Inadequately repaired lacerations through lacrimal drainage system may lead to persistent tearing
  • Delayed repair may lead to scarring or infection