Plastics Coach 005 was originally published on October 20th, 2020.
This 10-year-old girl presents with eyelid trauma from a dog bite. What are your next steps?
Analysis
Here, we see upper and lower avulsion injuries of the eyelid involving the medial canthus. Eyelid trauma can be classified into four types: margin involving injuries, extra-marginal injuries, avulsion injuries, and injuries involving tissue loss.
Providers should have a low threshold for imaging, exploration for foreign bodies, and suspicion of canalicular injuries; this patient had involvement of both the upper and lower canaliculi requiring surgical repair. Remember that primary repair yields better outcomes than secondary repair.
In this item's accompanying 15-minute video with Dr. Ahsen Hussain, assistant professor at Dalhousie University in Nova Scotia, we will review:
- How to identify and triage eyelid trauma
- Review the approach to evaluating for presence of open globe injury
- Review the management for eyelid trauma
Plastics Coach Tip
Utilize a systematic approach when evaluating a patient with history of trauma to ensure that injuries requiring emergent assessment (i.e. open globe) are not missed.
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