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Eyelid trauma is almost always caused by injury and thus requires immediate medical attention in order to avoid serious complications. At Cedars-Sinai Marina del Rey Hospital, our well-trained specialists will promptly attend to eyelid trauma cases to provide patients with the most suitable treatment approaches.
Eyelid trauma typically occurs after an injury to the eye. Injuries that can affect the eyelid can vary in severity depending on their cause. Eyelid trauma can be caused by foreign objects, such as glass, entering the eye, or by household chemicals. In such cases the injury should be tended to immediately to avoid the risk of developing serious complications, such as infection, damage to adjacent regions of the eye, ocular injury (corneal abrasion, conjunctival laceration), ptosis (drooping eyelids due to the stretching or injury of the muscle underneath the eyelid), tear duct injuries, orbital fractures, or even loss of vision.
Treatment for eyelid trauma depends on the severity and nature of the injury. In mild cases of blunt trauma, the patient will generally be advised to take proper care of the injury:
If the eyelid trauma is caused by an injury that has not further damaged the eye, applying ice packs during the first 24 to 48 hours can help reduce swelling. Hot compresses can also be used to speed up the absorption of hematomas. Other treatments may include:
Non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen are to be avoided, as they tend to stimulate bleeding and can also worsen the appearance of the affected eye.
Severe eyelid trauma produced by penetrating injury may require sutures (stitches). It is recommended that this procedure be performed within 12 to 24 hours of the accident to avoid further complications. Before suturing, the wound will be cleaned and irrigated with a saline solution to prevent infection and inflammation. If the injury was caused by an animal bite or by collision with a sharp object, antibiotics will also be administered to prevent infection. Local anesthesia is generally used for this procedure, although for children, general anesthesia may be used. Postoperative care includes treatment with antibiotics and pain relieving medicine to help reduce inflammation, prevent infection, and alleviate discomfort. The patient will also be required to maintain proper hygiene of the wound by applying antibiotic ointment if necessary and changing the bandage two or three times a day in the week following the procedure.
When the eyelid experiences complex structural changes following a penetrating injury, plastic surgery may be required to restore the function and appearance of the affected region. If there is major damage to the eyelid, grafts may also be used to replace any lost tissue. Depending on the type and severity of the injury, stitches will be removed within four to ten days. The recovery process may be anywhere between six to 12 months.
Possible complications, such as globe laceration, ptosis (due to severe trauma to the levator muscle), major damage to the lacrimal drainage system (lacrimal sac, lacrimal gland), retinal detachment or hemorrhage, iris laceration, or dislocated lens need to be addressed immediately. In these cases, surgical intervention is usually required to repair the affected area and underlying structures of the eye.
There are two types of eyelid trauma, depending on the nature of the injury which caused it:
Symptoms of eyelid trauma depend on the severity and nature of the injury, and whether it is accompanied by additional complications. The most common signs of eyelid trauma include:
Physical exams can quickly determine the severity and type of eyelid trauma, but additional tests are often required to make an accurate diagnosis. These tests can be extremely helpful in discovering underlying damage in the adjacent regions of the eye, as well as foreign bodies, which can infiltrate the surface of the eyelid following an injury. The most commonly performed procedures for diagnosing eyelid traumas are:
Complete Ophthalmic Exam: The doctor will perform a complete eye examination in order to determine the severity of trauma and identify any other potential damage to the eye. Visual acuity, movement of the eye, color and light perception, motion detection and function of the levator muscle will be carefully assessed. The retina and optic nerve may also be examined, along with the shape of the pupil, extraocular movements and the pupil's response to light.
X-rays: X-rays are often used to confirm the presence of a foreign object, which can enter underneath the eyelid's surface or further in the eye during injury.
Eye and Orbit Ultrasound: Ultrasounds can offer a detailed perspective of the eye and surrounding areas. Ultrasounds are not recommended if laceration of the globe is suspected.
CT scans: Computed tomography is probably the most efficient tool in diagnosing and assessing the severity of eyelid trauma and its potential complications. It can determine the exact location of a foreign body, as well as any orbital fractures.
Here are a few factors that may increase the risk of eyelid trauma:
Sex and age: Eyelid trauma is significantly more prevalent among men than women. Approximately 75% of eyelid trauma patients are males of active age. Women who suffer from eyelid trauma tend to be older in age. A significant difference has also been observed in the nature of the incidents that lead to injury:
Work environment: People who occupy higher risk jobs (i.e. in factories or workshops) are more likely to be involved in work-related accidents resulting in eyelid trauma. Workers who do not wear appropriate eye protection equipment and workers who are less skilled are at a significantly higher risk of injury.
Household: Accidents taking place in the home are the second most common cause of eyelid trauma. Most of these accidents involve chemical cleaners and disinfectants. Children are more prone to these types of injuries when they're not properly supervised.
Sports, outdoor activities and driving: Sports (particularly extreme sports), outdoor activities such as fishing, hunting, and reckless driving may also result in eyelid trauma. When proper safety measures are not taken, the risk of injury increases greatly. Causes of eyelid trauma injuries, either blunt or penetrating, are most often responsible for trauma to the eyelid. The most prevalent causes of such injuries are:
When eyelid trauma is the result of a penetrating injury, medical assistance should be sought immediately in order to avoid possible complications. Cases that involve large lacerations on the surface of the eyelid often require sutures or surgical intervention, and thus can only be treated by a medical professional, though blunt injuries affecting the eyelid and its appearance can sometimes be treated at home. These alternative remedies should be used along with doctor-prescribed treatment and medication:
Although there is no certain way to avoid injuries which can produce trauma to the eyelid, taking into consideration the following risk factors and their implications may help decrease your chances of injury:
Wear appropriate equipment to protect your eyes: Since the majority of eyelid traumas are caused by accidents related to the workplace, household chores, and outdoor activities and sports, using the proper protective eyewear is always recommended.
Keep cleaning products and other household chemicals in a safe place: Children are more prone to eyelid trauma resulting from contact with chemical substances. It's highly recommended that you lock these products in a drawer or room that children cannot access.
Wear a seatbelt while driving or traveling by car: Car accidents are another common cause of injury to the eye. Following standard safety measures as a driver or a passenger can significantly reduce your risk of being majorly injured in a collision. Observing the speed limit and being aware of your surroundings can drastically lower the chances of a car accident.
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