Emergency of Ocular Adnexa

Injuries to the ocular adnexal structures also need emergency care. Eyelid lacerations can be partial or full thickness, with or without tissue loss. The wounds should be cleaned, foreign body should be removed, and the lacerations of eyelid should be closed layer by layer. Lacrimal injury can induce dislocation and obstruction of lacrimal passage; therefore, it should be sutured and a supporting tube should be placed. Patients with orbital fracture may present impairment of eye movements and enophthalmos. Surgery is needed to restore the anatomy of orbit. Traumatic optic neuropathy may lead to variable severity of visual acuity loss ranging from normal to no light perception. Although corticosteroid and surgical decompression were reported to treat traumatic optic neuropathy, there is no randomized control trials supporting they can provide additional benefit compared to observation alone.