Introduction
Lacerations of the eyelid are common, due to the propensity of rubbing heads on anything in the vicinity.
Diagnosis
The problem is not the diagnosis but discovering the extent and eliminating any foreign material.
- Adequate sedation should be used in order to examine the lesion thoroughly
- Check for any corneal trauma
Treatment
Even quite severe lacerations heal remarkably well due to the excellent blood supply.
- Any devitalised tissue must be removed by selective debridement
- Do not remove flaps of skin unless they are necrotic
- If re-apposition of the edges is required then the wound must be thoroughly cleaned and irrigated (povidone-iodine diluted 1:30 is safe for corneal cleansing)
- Care must be taken to appose the edges correctly to maintain the eyelid anatomy. Staples could be considered instead of suture material, as the edges are not under tension. 3/0 vicryl with a swaged-on cutting needle is the easiest to use
- Systemic NSAID should be used for five to seven days to reduce pain and swelling.
- Systemic antibiotics are usually required
- Topical antibiotics are applied to the cornea in cases of corneal ulceration
- Tetanus prophylaxis is essential
References
- Grove, V. (2008) Conditions of the eye In Svendsen, E.D., Duncan, J. and Hadrill, D. (2008) The Professional Handbook of the Donkey, 4th edition, Whittet Books, Chapter 11
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