Injuries to a patient’s eyelids are common, and can be serious because of the danger to his eyes under them, either immediately, or later if scar tissue distorts his lids and exposes his cornea. The injury can involve part of the thickness of a lid, or its whole thickness, including its tarsal plate, sometimes with tissue loss.
When you repair a torn eyelid, start by putting a suture in the lash line immediately behind the patient’s eyelashes. If you align his lash line correctly, it will align the other structures. The secret of success is multiple small sutures and accurate repair. The common mistake is to use large instruments and coarse sutures.