From the Research
The first intervention after penetrating trauma to the upper eyelid is to protect the eye from further damage by placing a rigid shield (not a pressure patch) over the affected eye without applying pressure to the globe, as recommended by general medical principles and supported by the most recent and relevant studies 1, 2. This approach is critical because the upper eyelid protects the cornea and globe, and penetrating injuries may extend deeper than initially apparent, potentially involving the globe itself or other orbital structures.
Key Considerations
- Do not attempt to remove any impaled foreign objects, as this could cause additional injury to underlying structures 2.
- Avoid manipulating the eyelid excessively and refrain from instilling medications or eye drops until proper evaluation.
- The patient should be instructed not to rub or touch the eye.
- Hasty manipulation could convert a lid injury into a more serious ocular injury.
Additional Measures
- Pain management with oral analgesics may be appropriate, but topical anesthetics should be avoided as they can delay healing and mask worsening symptoms.
- Tetanus prophylaxis should be administered if the patient's immunization status is not up to date.
- Urgent ophthalmologic consultation should be arranged to further evaluate and manage the injury, considering the potential for complications such as endophthalmitis, as discussed in studies like 3.