Eyelid Laceration

It is important to take your pet to a veterinarian quickly after suffering any laceration (cut) injuries to the eyelid as disruption of normal eyelid closure can lead to further problems if not repaired promptly. It is rare for any portion of the eyelid to be removed by the trauma. However, because of extensive swelling, it may seem that there are portions missing. Even if wounds and injuries appear old when discovered or extensively damaged, prompt surgical intervention is still advised to provide appropriate long-term eyelid function. After surgical correction, your pet will require both topical (to the eye) and oral antibiotics as well as pain medication.

Third Eyelid and Conjunctival Laceration

The conjunctiva is the soft, moist pink tissue surrounding the eye. Small cuts and injuries to the conjunctiva typically do not need to be repaired surgically as they often rapidly heal on their own. The third eyelid is the membraneA pliable sheetlike structure acting as a boundary, lining, or partition in an organism. that comes up from an angle near the bridge of the nose where the upper and lower eyelids come together. If lacerations of the third eyelid result in exposure of its cartilageFirm, whitish, flexible connective tissue., they should be surgically repaired to keep the cartilageFirm, whitish, flexible connective tissue. from damaging the eye.

Corneal Trauma

The cornea is the clear front surface of the eye. Superficial ulcersAn open sore on an external or internal surface of the body, caused by a break in the skin or mucous membrane that fails to heal. are confirmed by staining, treated with eye drops prescribed by your veterinarian and often will heal within a week if no underlying conditions exist. Corneal lacerations and injuries are far more serious and, if they are deep, must be surgically repaired immediately to preserve your pet’s vision. As the size of the laceration increases, the likelihood of retaining vision decreases. If your pet is showing signs of corneal trauma (e.g., squinting, pain when exposed to light, cloudiness of the cornea, excessive tearing), it is imperative to see a veterinarian as soon as possible.

Proptosis

Proptosis results from trauma and injuries that causes the eye to protrude forward (out of the eye socket), becoming trapped by the eyelids. Dogs with very short noses and prominent eyes are at the highest risk. Whether it can be saved depends on how much of the blood and nerve supply to the eye has been disrupted and for how long, so prompt treatment is essential. The majority of proptosed eyes become blind, regardless of treatment. Not all proptosed eyes are replaced; some will need to be removed immediately if the damage is severe. The good news is that most dogs do very well with only one eye, and results in most cases are cosmetic. A procedure called tarsorrhaphy may be performed, in which the eyelids are temporarily sutured together to replace and protect the injured eye while swelling goes down over a period of about two weeks.

Trauma-Induced Anterior Uveitis

Sometimes trauma to the eye causes bleeding or inflammation within, resulting in “anterior uveitis.” Anterior is the medical term for “front part,” and uveitis is the medical term for inflammation of the part of the inside of the eye. Symptoms of these injuries include cloudiness and/or blood in the eye and redness of the surface. It is important to seek prompt treatment of this inflammation by a veterinarian to prevent development of glaucomaA condition of increased pressure within the eyeball, causing gradual loss of sight. and loss of vision. Disruption of the lens is particularly likely to cause loss of vision and possibly also loss of the eye.

Foreign Bodies

Corneal foreign bodies may range from small plant seeds that become adhered to the eye surface and can be removed by flushing to thorns or other sharp fragments that completely penetrate the cornea and might result in corneal laceration. Most conjunctival foreign bodies can be removed after applying eye drops to numb it, with no surgical closure required unless the defect is very large.

Foreign bodies making their way completely into the eye may or may not need to be removed based on the reactivity of the material and location. Ultrasound, X-ray, MRI, CT or a combination of these may be necessary in order to determine the location and nature of the foreign body. Foreign bodies themselves may result in permanent visual loss; subsequent damage from disruption of the lens capsule or inflammation within the eye also may result in vision loss.

Because of the many factors involved in determining the prognosis and most appropriate treatment plan, referral to a specialist should be considered in these cases if the eye is to be saved.

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Reference:
Westermeyer, Hans. “Management of Common Eye Injuries.” World Small Animal Veterinary Association World Congress Proceedings, 2013.