Traumatic canalicular laceration and complex eyelid injury in a newborn delivered by forceps

We present a neonatal case of complex upper eyelid lacerations with canalicular injury following a forceps-assisted vaginal delivery. Mother's insistence on vaginal delivery despite obstetric advice of caesarean section led to obstructed labour requiring forceps delivery. The neonate presented with four full-thickness lacerations of the right upper eyelid, including injury to the upper canaliculus. Immediate surgical repair with canalicular stenting was performed. A corneal ulcer developed secondary to stent-induced mechanical trauma. Early stent removal with topical fortified antibiotics led to ulcer resolution. By 3 months, the lid and cornea healed with a favourable anatomical and functional outcome with a residual eyelid notch and paracentral corneal opacity. This case emphasises the complexity of managing maternal preferences in obstetric care, particularly when they conflict with clinical recommendations, and emphasises that timely ophthalmic microsurgical intervention can result in excellent recovery, even in complex neonatal eyelid and canalicular injuries.