The eyelids are defined as either of two movable folds, upper and lower, that protect the surface at the front of the eyeball; also called palpebra. Eyelids, loss of a portion of the structure would mean that the eye is deprived of protection and a cover. Blinking of the eyelid spreads the tear film and keeps the cornea and conjunctiva from becoming dehydrated.

Possible causes for loss of a portion of an eyelid may include: trauma; gunshot; burns; explosions; motor vehicle accidents; assaults; or sports-related accidents.

The condition involves visible loss of tissue from the superficial to the deep layers. The eyelid tissue layers are: skin, muscle, areolar tissue, tarsal plates, and palpebral conjunctiva. Eyelashes may be lost (see diagnostic code: 6024 eyelashes, loss of, complete, unilateral or bilateral); and symptoms of conjunctivitis (see diagnostic code: 6018 conjunctivitis, other, chronic) and lagopthalmos (see diagnostic code: 6022 lagopthalmos) may be present. Manifestations may include: redness; tears; exudate; edema; photophobia; and sensations of a foreign body.

Tests for the condition may include: inspection of the lids and conjunctiva; direct and indirect ophthalmoscopy; hand flashlight; slit lamp; fluorescein staining; visual acuity; and visual fields.

Immediate treatment usually involves irrigation of the wound with saline, and removal of any particulate matter. If a primary surgical repair cannot be done immediately or within 24 hours, then edema will set in and delay closure. Systemic antibiotics are usually prescribed for open wounds, and specific treatment for the eye will depend on the amount of lid loss. Burns to the lids, which would result in loss of a portion of the eyelid and eye injury, are first treated with topical antibiotics, topical lubricants and sterile dressings. Tarsorrhaphy (lid repair) and skin graft may take place after lid edema has subsided.

Loss of coverage of the eyeball by the eyelids could lead to exposure keratitis; conjunctivitis (see diagnostic code: 6018 conjunctivitis, other, chronic); or post-trauma entropion (see diagnostic code: 6021 entropion).

• May be entitled to special monthly compensation where the Veteran has a single service-connected disability rated as 100% with additional service-connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service-connected disability and involves different anatomical segments or bodily systems. See  38 CFR 3.350(i)(1) – Special Monthly Compensation (SMC).

• Consider entitlement to specially adapted housing under 38 U.S.C. 2101(a)(2)(A)(i) if there is visual impairment to the degree specified in 38 CFR 3.809(b)(2).

• The veteran, spouse, surviving spouse or parent will be considered in need of regular aid and attendance if he or she is blind or so nearly blind as to have corrected visual acuity of 5/200 or less, in both eyes, or concentric contraction of the visual field to 5 degrees or less (38 CFR 3.351(c)(1)).

• Consider entitlement to automobile allowance and/or automobile adaptive equipment if there is visual impairment to the degree specified in 38 CFR 3.808(b)(3).

• Review for entitlement to special monthly compensation under 38 CFR 3.350.