The skin on the eyelid is the thinnest in the body and distensible allowing the eyes to open and close at ease. If the skin is lost or poorly repaired as a result of trauma, the eyes may have difficulty in closing. This man was involved in a car accident in a rural area 6 weeks earlier. The laceration was repaired by an inexperienced medical officer who failed to appose the wound properly. This resulted in poor cosmesis and the patient was unable to shut his eye at night. The picture shows that the skin was sutured poorly to the lateral side of the upper lid resulting in shortage of skin in the middle part of the eyelid and the lateral side was bulky due to the excess skin.
To improve the appearance of the patient's eyelid and allow the eye to shut properly, reconstruction was undertaken as shown in the photographs below. The area of scarring was released and covered with skin flap taken from the lateral side of the upper lid.
The picture below was taken 2 months after the reconstruction showing much improved cosmesis and normal eyelid closure.