What Are Eyelid Lacerations?

Medically Reviewed by Poonam Sachdev on August 24, 2022
5 min read

Of all the sensory organs, the most sensitive, delicate, and easily injured are the eyes. Around 2 million U.S. adults experience eye injuries annually. 

Luckily, we have eyelids to ordinarily protect our eyes from damage or injuries caused by external stimuli like dust, insects, and other projectiles. However, our eyelids are subject to damage as well. Read on to learn more about eyelid lacerations, which is a type of injury caused to your eyelid. 

Eyelid lacerations are a type of facial trauma injury in which the eyelid is physically damaged. Eyelid lacerations are deeper than superficial scratches and usually involve a tearing of the skin and underlying flesh.

Your eyelid is unique because it has the thinnest layer of the body’s skin without any underlying fat. Because it is so delicate, depending on the location and severity of the eyelid laceration, the corresponding part of your eye, such as your eyeball or tear duct, may also be damaged. Eyelid lacerations may also involve the immediately underlying muscle layer, thus affecting the opening and closure of eyelids.

You can prevent many eyelid lacerations by taking certain safety measures like the use of helmets and protective eyewear while traveling, playing sports, and navigating hazardous workplace environments. It is often best to supervise children and older adults at all times because they are at a higher risk of falling or bumping into things, leading to facial injuries like eyelid lacerations.

Eyelid lacerations are caused by sharp objects that penetrate the various layers of your eyelids or by blunt objects that cause tearing and separation of your eyelid layers. 

Eyelid injuries are most commonly observed in children or adolescents. They are usually caused by falls, animal bites, and accidental collisions with sharp objects like the edges of a table. In young adults, the most causes of injury include sports, vehicular accidents, and punches or eye gouging during fistfights.

The common risk factors for eyelid lacerations, therefore, include:

  • Age. Eyelid lacerations account for around 20% of facial injuries occurring in children. The age groups that are most vulnerable to eye injuries include small children, teenagers, and young adults. Older adults are also likely to experience falls due to poor eyesight or coordination, though, leading to a similarly higher risk of developing eyelid lacerations.
  • Sex. Eyelid lacerations have been observed in more males than in females because they are more likely to participate in high-risk activities, jobs involving strenuous manual labor, and physical violence.
  • Environmental factors. These can include various factors like animal bites (usually dogs, cats, or insects), scuffles, and motor vehicle accidents.
  • Medical injuries. These can include injuries to a baby occurring due to birth trauma during difficult deliveries or a C-section.
  • Workplace injuries. These can include injuries caused by heavy machinery with sharp or pointy edges, machines with parts moving at high speeds, and machines with hooks or other sharp surfaces at eye level. Such injuries are most likely to occur in new or untrained workers.

Eyelid laceration symptoms include:

  1. Bleeding or oozing fluid discharge from your eyelid, eye, or the surrounding areas
  2. Redness with or without swelling around your eye or eyelid
  3. Pain or irritation in your eye, eyelid, or neighboring facial areas
  4. Numbness of your eyelid or the surrounding areas
  5. Blurry, distorted, or double vision 

Lacerations of eyelids are diagnosed based on your history, physical examination, and lab results. Here is what these steps involve:

History. The eye doctor will ask about how and when you received the eye injury, whether you performed any first aid, and what medications (if any) you took or applied to the injury. 

You may also have to provide details like whether you were under the influence of alcohol or any drugs, whether your injury was exposed to any toxic or corrosive chemicals, and whether you were wearing any protective gear when the injury occurred.

The doctor may request recent pictures taken before the injury as a comparison to assess the severity of your injury. They will ask about your relevant medical histories such as falls, a history of abuse, or frequent blurry vision, whether you have any other illnesses, and when you took your last tetanus shot. 

Physical exam. The doctor will then perform a complete physical exam, including a detailed eye exam. If they suspect the presence of a foreign body or a greater degree of trauma than is visible, they will recommend radiological imaging like a computed tomography (CT) scan or magnetic resonance imaging (MRI).

Diagnostic tests. Blood tests may be required in cases where infections or toxins are suspected, to check your alcohol or other chemical levels, in cases of severe blood loss, and to obtain baseline levels before prescribing certain medications. 

In cases of facial trauma, accidents, sports injuries, and suspected foreign bodies, your doctor may suggest imaging tests like CT or MRI to rule out severe injuries like a ruptured eyeball, orbital bone fractures, or brain injuries.

Some eyelid laceration types include partial-thickness or full-thickness lacerations, lacerations involving the lid margin, lacerations involving the tear ducts, lacerations involving a foreign body, and lacerations with avulsion or orbital fat prolapse.

Depending on the location and severity of your eyelid laceration, your eye doctor will recommend a suitable treatment regimen. 

Most eyelid lacerations are treated within 12 to 24 hours of the injury to decrease the likelihood of developing any complications. 

The first step in treatment usually involves cleaning the site of the injury with saline and removing any visible debris, foreign particles, or blood clots around the wound. This can increase visibility, reduce the risk of subsequent swelling or infection, and assist in wound healing and repair. 

Lacerations greater than 2 millimeters in length generally require sutures. The doctor will numb the area around the injury and stitch the wound closed. The stitches are usually removed in 4 to 7 days, but those at the lid edges may be retained for 5 to 10 days. Even after suture removal, you may have a scar for some time.

If you haven’t taken a tetanus shot in a while, your doctor might recommend one as a precaution. To prevent infections, the doctor may also prescribe some antibiotics and pain killers if you need them.

In rare cases when the eyelid laceration is associated with other serious injuries like a ruptured eyeball, a foreign body embedded deep in the eye, or damage to the tear ducts or orbital bone, surgery may be required. 

Once treatment is completed, don’t skip any follow-up appointments, and report to your doctor immediately if you notice any aftereffects like shooting pains or vision problems.

The eyelids are the gatekeepers of the eyes, so don’t ignore or take eyelid lacerations lightly. Seek eyelid laceration treatment as early as possible for complete and rapid recovery.