From the Guidelines
For a toddler with an eyelid laceration and swelling from blunt trauma, immediate medical attention is necessary to prevent complications and ensure proper healing. The child should be taken to an emergency department or pediatric ophthalmologist promptly, as eyelid lacerations often require professional evaluation and possibly suturing to ensure proper healing and prevent complications 1. While waiting for medical care, the area should be cleaned gently with sterile saline or clean water, and gentle pressure with a clean cloth should be applied to control any bleeding. It is crucial not to attempt to remove any foreign objects embedded in the eye or eyelid, as this can cause further injury. A cold compress (wrapped in a cloth) can be applied for 10-15 minutes to reduce swelling, but direct pressure on the eye itself should be avoided. Pain can be managed with children's acetaminophen (10-15 mg/kg every 4-6 hours) or ibuprofen (5-10 mg/kg every 6-8 hours) as appropriate for the child's weight. The child should be kept calm and prevented from rubbing the injured eye to minimize the risk of further injury. Given that traumatic injury is the leading cause of noncongenital monocular vision loss in children, as noted in the study 1, prompt medical attention is crucial to prevent long-term vision problems. The study also highlights the importance of assessing for signs of orbital injuries, including periorbital soft tissue swelling, ecchymosis, hyphemia, subconjunctival hemorrhage, diplopia, restriction of ocular movement, or vision loss, which can be associated with blunt trauma to the eye 1. Overall, the goal of treatment is to minimize scarring, preserve function, and prevent complications that can affect vision development in children.
From the Research
Injury to Eye Lid of Toddler Involving Laceration and Swelling from Blunt Trauma
- The provided studies primarily focus on the diagnostic performance of CT scans in assessing globe rupture and orbital fractures in patients with blunt facial trauma, rather than specifically addressing toddler eye lid injuries 2, 3, 4.
- However, these studies can provide some insight into the potential consequences of blunt trauma to the eye area, including the possibility of globe rupture and orbital fractures 2, 3.
- A study published in 2016 found that lateral wall fractures were an independent risk factor for globe ruptures, and medial or inferior wall fracture was a protective factor 2.
- Another study published in 2021 found that ocular injuries occurred more often in patients without orbital fractures, and that patients with ocular injuries had shorter orbit depths compared to those without ocular injuries 3.
- A 2014 study evaluated the CT characteristics of globe rupture and found significant differences between ruptured and non-ruptured globes with respect to intraocular hemorrhage, lens dislocation and destruction, and other factors 4.
- While these studies do not directly address toddler eye lid injuries, they suggest that blunt trauma to the eye area can have serious consequences, including globe rupture and orbital fractures, and that CT scans can be useful in evaluating these injuries 2, 3, 4.