Pediatric emergency medicine trisk 3682 3682
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Triage Considerations
Children with high-risk lacerations, as detailed above, should be triaged rapidly
and ophthalmology consultation initiated promptly.
TABLE 114.3
EYELID LACERATIONS
Consult ophthalmology if laceration is associated with:
Full-thickness perforation of lid
Ptosis
Orbital fat prolapse
Involvement of lid margin
Possible damage to tear drainage system
Tissue avulsion
Globe injury
FIGURE 114.9 Lower eyelid laceration involving tear drainage system. Thick arrow indicates
lower eyelid punctum, which has been displaced laterally. Thin arrow indicates normal course
of canaliculus, which drains tears from the puncta to the lacrimal sac located medially.
Management
Lacerations of the periorbital skin and superficial eyelid may be managed by
standard skin closure techniques. Tissue adhesives are widely used to close
superficial, nongaping facial lacerations with good cosmetic outcomes. It is
