Eyelid trauma

• Periocular haematoma:

  • Usually caused by blunt force to the eyelid or forehead
  • Must exclude traumatic injury to the globe or orbit, retrobulbar haemorrhage or fractures
  • Usually self limiting - cold compress and oral analgesia
• Lacerations:

  • Suspicion of foreign bodies which cannot be visualised merit radiological investigation (plain X-ray or CT).
  • Management of a lid laceration should include:
  • Irrigation: the laceration should be copiously irrigated with normal saline to clear debris and prevent infection
  • Tetanus: confirm tetanus status and follow local guidelines
  • Antibiotics for any surrounding cellulitis
  • Horizontal and small, simple lacerations away from the lid can be managed laissez-faire or with cyanoacrylate glue
  • All complex lacerations should be referred following initial treatment for specialist repair