Be Careful, You’ll Poke Your Eye Out
- Posted on: Jul 15 2021
“Be careful, you’ll poke your eye out”
This is the classic statement I remember my mom telling my brother and me as we grew up. We were two rambunctious little boys who were always climbing or throwing things at each other. During my ophthalmology residency, I spent many a night repairing eyes that had been punctured through various types of trauma. In my Oculo-Facial Plastic Surgery fellowship, I repaired far more traumatized eyelids than I ever did eyeballs. The reason is that as soon as a threat to cause potential harm comes near your eye, the first reflex is to close the eyes.
Closing your eyes shields the delicate tissue of the eyeball itself and protects the vision, but the eyelid takes the brunt of the force. It is amazing how resilient the eyelids are and their capacity to shield the eyeball from trauma. The eyelid has a dense structure, just above the eyelashes, called the tarsus. This cartilage-like structure is very tough and can protect the eyeball from sharp objects.
While the eyelids are good at absorbing much of the force that can come with a traumatic accident they can still be damaged. During my fellowship and time working on the teaching staff of the Thomas Jefferson University School of Medicine I have seen many eyelid traumas. These injuries ranged from an Amish man who was bitten by his horse, to a man who tore his eyelid on a tree branch while visiting a gardening store, dog bites, home repair accidents and everything in between.
Repairing eyelids is very complex. There are multiple eyelid layers, including the skin, muscle layer, tarsus, and conjunctiva. Any of these layers can be disrupted and must be carefully reconstructed layer by layer. If skin or tissue is missing, a skin graft must be placed or a tissue flap arranged to cover the defect. The eyelid is a very well vascularized structure, meaning that when injured the eyelids bleed a lot, but that strong blood supply also means that the lids are quick to heal.
If you ever have trauma to the eyelid, or anywhere on the face, please come in to have the eyelid expert repair it.