Sunday, November 4, 2012

A Patient with Problem Closing His Eye after Road Traffic Accident

This motor biker was involved in a road traffic accident resulting in loss of his upper eyelid skin. The repair performed in the emergency room did not replace the lost skin and the patient was left with difficulty in closing his left eye which gave him constant eye pain and blurred vision.
Left upper lid contracture from skin loss resulting
in closure problem.
He was referred to the eye clinic for further management. On examination, there was skin shortage resulting in left upper lid skin contracture. I performed a Z-plasty to lengthen the eyelid vertically and the lid closure improved.

Steps taken to correct the contracture.
a. and b. before the operation.
c. marking of the z-plasty;
d. creation of the z-plasty and release of scar tissue;
e. the contracture released with good eye closure;
f. at the end of the procedure, the upper and lower
eyelids were tied together for five days
 to prevent skin contracture.
3 weeks after the operation. The upper eyelid had been
 lengthened vertically and the eye closure improved.

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