Specialty Distribution and Treatment Methods of Eyelid Lacerations in a Tertiary Care Center: Implications for Resident Education in Ophthalmology

Background While eyelid laceration repairs can be performed by many different specialties, literature investigating the incidence of such repairs is limited. If the majority of these repairs are performed by other, non-ophthalmology specialties, there may be limited opportunities for ophthalmology residents to gain the necessary skills and meet Accreditation Council for Graduate Medical Education (ACGME) case log requirements. The purpose of this study was to determine the frequency of eyelid lacerations and respective treatment methods performed by different specialties within a tertiary care center. Methods A retrospective chart analysis was performed. The electronic health record was queried to identify cases of eyelid laceration between 2011 and 2020 at Rush University Medical Center, a tertiary care center in Chicago, Illinois, USA. The treating physician medical specialty and treatment method were recorded. Results Of the 468 total cases of eyelid laceration identified, 303 (64.74%) were treated by emergency medicine, 98 (20.94%) by ophthalmology, 27 (5.77%) by plastic surgery, 20 (4.27%) by primary care, 11 (2.35%) by pediatrics, and 9 (1.92%) by otolaryngology. Of the total number of cases, 310 (66.24%) were treated using sutures. Suture-treatment occurred during 181 (59.74%) of emergency medicine’s total cases, 86 (87.76%) of ophthalmology’s total cases, 26 (96.30%) of plastic surgery’s cases, 6 (30%) of primary care’s cases, 3 (27.27%) of pediatrics’ cases, and 8 (88.89%) of otolaryngology’s cases. Year of presentation significantly affected the number of cases that ophthalmology treated, with ophthalmology cases increasing over time (p=0.032). Conclusions Although ophthalmology-involvement has increased throughout the years, ophthalmology was only involved in a minority of total eyelid laceration cases while emergency medicine was involved in most cases. The findings of this study highlight the importance of supporting ophthalmology residents to gain exposure completing eyelid laceration repair to meet ACGME case log requirements. Collaborations with other specialties may be necessary to ensure that residents have sufficient opportunities to gain these required skills. Additionally, targeted programs for ophthalmology residents to be involved with the diagnosis and management of eyelid lacerations may help to improve this involvement and provide residents with the opportunity to meet ACGME requirements.