Pattern causes and management of eyelid and adnexal injuries in a tertiary hospital

Abstract

Purpose: To describe the pattern, causes and management of eyelid and adnexal injuries in a tertiary care hospital. Materials and Methods: A prospective study of 64 patients presenting to the emergency and outpatient department with eyelid and adnexal injuries from June 2017 to June 2019 with or without any globe injuries was carried out. Thorough ophthalmic evaluation was done for all. Wound was thoroughly washed with saline and broad-spectrum antibiotics were started for all patients. They were divided into only eyelid, canalicular and periocular injuries with or without globe injuries and orbital fractures. All the data were then analysed. Results: Out of 64 patients 49 patients (76.5%) with eyelid and adnexal injuries were due to road traffic accident (RTA).1was due to a bull horn injury.7 were due to dog bite, 6 were due to self-fall and 1 was due to injury with cricket ball. 51(79.6%) patients were male and 13 were female. Amongst the RTA cases 2 patients had avulsion injury.1 patient had foreign body (glass pieces) inside the wound.2 patients had associated ocular injuries. 26 patients had associated orbital fractures. 2 patients had associated ocular injuries. 27 patients had eyelid injuries. 40 patients had adnexal injuries whereas 7 patients had canalicular injuries. The most common complication encountered during the post-operative period was wound site scarring in 11 patients. They were treated with 5 fluoracil and triamcinolone injections. 1 patient had MRSA infection. Primary repair was the most common surgery performed. All the surgeries were performed within the first 72 hours of admission. Conclusion:From our study we concluded that RTA is the most common cause and men were most commonly affected. Such injuries have varied presentations and management must be well planned and thought out to achieve good anatomical apposition as well as good cosmesis to avoid multiple surgeries.