COMPARATIVE STUDY
ENGLISH ABSTRACT
JOURNAL ARTICLE
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[Eyelid injuries: epidemiological aspects].

PURPOSE: To present epidemiological data on eyelid trauma which appear rarely in the literature.

PATIENTS AND METHODS: Medical records of 180 patients given surgical treatment for eyelid injuries at the ophthalmology department of LMU Munich between 1997 and 1999 were evaluated. Clinical findings of eyelids and eyeballs, surgical procedures and complications during wound healing were considered.

RESULTS: Out of 180 patients, 140 suffered blunt trauma of which 66 were due to manual work, 38 to sudden falls, 23 to violence, 7 to motor vehicle accidents and 6 to sports. From 26 cutting injuries caused by glass, 12 were caused by broken spectacles, 8 were caused by sudden falls, 4 by violence and only 2 by car accidents. Clinically 85 patients showed injuries of the upper eyelid, 55 of the lower and 40 of both lids. The lid margin was affected in 43 patients and the lacrimal drainage system in 28. Wound contamination occurred in 34 patients, 19 had foreign bodies and 13 loss of tissue. Accompanying injuries of the face was noticed in 16 patients and of the eyeball in 79 patients of which 31 were superficial, 36 were eyeball contusions of varying severity, 12 were perforations or ruptures and 4 patients additionally had orbital bone fractures. The average time from injury to surgery was 3.3 h. A total of 100 patients needed simple skin suturing, 26 sutures to the skin and subcutaneous tissue including the orbicularis and levator muscle, 43 needed readaption of the lid margin and 24 repair of the canalicular system. Post-operatively only one patient developed a necrosis and one an infection.

CONCLUSIONS: In eyelid trauma, the lid margin is affected in 24% and the lacrimal drainage system in 16% of all injuries. Our data also showed a high association (44%) of eyelid injuries with trauma to the eyeball. This emphasises the necessity for eyelid injuries to be treated primarily by an ophthalmic surgeon, although difficult primary reconstruction and early complications in particular, are relatively rare.

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