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Triage Considerations Children with high-risk lacerations, as detailed above, should be triaged rapidly and ophthalmology consultation initiated promptly TABLE 114.3 EYELID LACERATIONS Consult ophthalmology if laceration is associated with: Full-thickness perforation of lid Ptosis Orbital fat prolapse Involvement of lid margin Possible damage to tear drainage system Tissue avulsion Globe injury FIGURE 114.9 Lower eyelid laceration involving tear drainage system Thick arrow indicates lower eyelid punctum, which has been displaced laterally Thin arrow indicates normal course of canaliculus, which drains tears from the puncta to the lacrimal sac located medially Management Lacerations of the periorbital skin and superficial eyelid may be managed by standard skin closure techniques Tissue adhesives are widely used to close superficial, nongaping facial lacerations with good cosmetic outcomes It is

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