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Patients who sustain facial trauma often have swollen eyelids. They may be so swollen that it is impossible to pull back the eyelids for an ocular exam. You use one of our “Tricks of the Trade”ideas and attempt to “roll” the upper eyelid using the Q-tip trick (above).

Fresh blood on the face, however, makes the Q-tip a little slippery along the upper eyelid, preventing an adequate view of the eye itself.

Trick of the Trade

Apply benzoin along the lower and upper eyelid to increase your traction.

  • Clean and dry the lower and upper eyelid so that they are not bloody.
  • Apply a thin layer of benzoin adhesive fluid along the eyelids, being careful not to contact the eye or eye lashes.  
  • The dried benzoin allows easier traction when retracting the eyelids.
  • Use your fingers or Q-tips to gently retract the eyelids.
 
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Thanks to Dr. Duong for this great tip and the patient for consenting to have his photo taken for educational purposes.

Michelle Lin, MD
ALiEM Editor-in-Chief
Professor and Digital Innovation Lab Director
Department of Emergency Medicine
University of California, San Francisco
Michelle Lin, MD

@M_Lin

Professor of Emerg Med at UCSF-Zuckerberg San Francisco General. Founder of ALiEM @aliemteam #PostitPearls https://t.co/7v7cgJqNEn
Michelle Lin, MD