Eyelid Trauma: General Considerations





Ashok K. Grover

Dr. A.K. Grover is recipient of Padmashri Award, one of the highest civilian awards by the President of India for his services to Ophthalmology. He is Chairman, Department of Ophthalmology at Sir Ganga Ram Hospital and Vision Eye Centre in New Delhi.Dr. Grover is Chairman of Subspecialty Education Committee, International Council of Ophthalmologist (ICO), Councilor at large of the Asia Pacific Academy of Ophthalmology (APAO), Board Member of the Afro Asian Council of Ophthalmology (AACO), and Vice President of the Ocular Trauma Society of India (OTSI). He is Past President of the Asia Pacific Society of Ophthalmic Plastic and Reconstructive Surgery (APSOPRS), Oculoplastics Association of India (OPAI), and All India Ophthalmological Society (AIOS).Dr. Grover serves on the Editorial Board of the Asia Pacific Journal of Ophthalmology, Indian Journal of Ophthalmology, Nepalese Journal of Ophthalmology, Journal of International Medical Science Academy, Ocular Surgery News (Asia Pacific Edition), and is a reviewer for several international/national journals. He is an examiner for FRCS (Glasgow).Dr. Grover has received numerous prestigious Awards and Orations including the Distinguished Service Award from Asia Pacific Academy of Ophthalmology, Honorary FRCS, Honorary Fellowship of International Council of Ophthalmology (FICO), Col. Rangachari Award for the best paper from the All India Ophthalmological Society, and other numerous International and National Orations.Dr. Grover has authored/edited 4 books, written over 60 chapters in textbooks, has over 75 publications, and over 1000 presentations at international and national levels. He has chaired sessions, been Guest Speaker, and done live surgery all over the globe including the World Congress, APAO, Afro Asian Academy, American Academy, APSOPRS, and National meetings.


 




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Saurbhi Khurana

Dr. Saurbhi Khurana got her MBBS degree from the Maulana Azad Medical College in the year 2006. She did her MD in ophthalmology from Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi in the year 2009. She was a senior resident at the same institute in the Department of Oculoplasty and Pediatric Ophthalmology till 2012. Following her senior residency, she did an oculoplasty fellowship at the Leicester University, UK. She has authored many peer-reviewed articles and is an invited faculty at various conferences. She is a skilled oculoplastic and aesthetic surgeon.

 




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Shaloo Bageja

Dr. Shaloo Bageja is working as a consultant in the Department of Ophthalmology at Sir Ganga Ram Hospital since January 2006. She is working as an anterior segment surgeon with special interest in Oculoplastics.

Dr. Shaloo Bageja is representing Ocular Trauma Society of India as North Zone representative. She has also served as joint secretary of the Ocular Trauma Society. She was the organizing secretary of the APSOPRS-OPAI meeting held in New Delhi in 2014.

Dr. Shaloo Bageja has written 38 chapters in textbooks, has over 15 publications in peer- and non-peer-reviewed journals. She has presented over 25 papers at the national level. She has won the best paper presentation in oculoplastic session in All India Ophthalmic Society meeting. She has chaired sessions and has been guest speaker in AIOS, OPAI, and DOS meetings.

 



Eyelid injuries can occur due to a number of causes. In recent times, eyelid injuries are on the rise primarily because of the increasing incidence of road traffic accidents, industrial mishaps, and intentional assaults on the human body. Injury to the eyelids, lacrimal system, or orbital wall may be isolated or may occur in association with midfacial injuries.

It is important to look for associated systemic/facial injuries and address those before planning a repair of the eyelid. Moreover, any obvious/occult globe perforation should be carefully looked for and repaired first [1].

Every case of eyelid trauma is unique, and a thorough knowledge of anatomy and principles of repair is important for management of these cases. A meticulous planned repair is a must for achieving maximal functional and cosmetic outcome and preventing long-term complications.


History


A precise history is essential to assess the severity of injury. It is important to elicit the mode of injury, whether it is with sharp or blunt objects or due to thermal or chemical injury or due to dog bites. In cases of animal bites, a complete tetanus immunization history is obtained, and if required, proper immunization should be given. For chemical injuries, thorough irrigation of the eyes and adnexa is vital before any further intervention [2].

In some cases, an ophthalmologist can anticipate the extent and severity of injury from the mechanism of injury. Blunt trauma will lead to greater tissue edema and disruption. On the other hand, injury with sharp objects will usually create a direct cut.

In cases of penetrating injury, a suspicion of foreign body must be kept in mind.


Examination of the Patient


Patient’s injury must be dealt according to the priority. The basic “ABCs” (airway, breathing, circulation) must be evaluated, before proceeding to the management of localized injury. Repair of globe takes precedence over repair of eyelid laceration. In adnexal injury, the decision whether to repair the wound immediately or to delay repair depends on the degree of tissue edema or the presence of hematoma or infection.


Ophthalmological Examination


The ocular examination should be performed meticulously. Observation of ocular adnexa is done before manipulating the injured eye.

Oct 16, 2017 | Posted by in OPHTHALMOLOGY | Comments Off on Eyelid Trauma: General Considerations

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