W. Va. Code R. § 85-20-29

Current through Register Vol. XLI, No. 24, June 14, 2024

Section 85-20-29 - Treatment Guidelines: Canalicular Laceration

29.1. Laceration in the medial eyelid may injure the upper or lower canaliculus or lacrimal sac, resulting in constant tearing or abscess in the lacrimal sac (dacryocystitis). The presence of an infection within the lacrimal system usually requires surgical repair.

29.2. The appropriate diagnostic criteria consists of a laceration in the medial eyelid. Any laceration to the punctum may include canalicular laceration. Tearing or bloody tears and laterally displaced punctum may be present.

29.3. The appropriate diagnostic tests and examinations consist of a comprehensive examination, including visual acuity, slit lamp, examination, dilated fundus examination and probing of the canaliculus. Orbital x-rays or CT scan is appropriate if a fracture or foreign body is suspected.

29.4. Appropriate treatment is as follows:

a. Outpatient treatment is appropriate for simple lacerations and repair. Treatment consists of surgical repair including stent placement and topical drops and oral antibiotics as indicated.

b. Inpatient treatment is appropriate for contaminated or complicated wounds. Treatment consists of the following:

1. Surgical repairing; may include complex reconstruction;

2. Antibiotics and topical medications as indicated; and

3. Lacrimal bypass surgery if repair is unsuccessful.

29.5. The estimated duration of care in uncomplicated cases is two weeks with follow-up in 3 - 6 months.

W. Va. Code R. § 85-20-29