What is trichiasis?
Trichiasis describes eyelashes that are misdirected towards the eyeball, and should not be confused with entropion where the eyelid itself is rolled inwards against the eye. This is an important distinction, as the treatment is not the same.
What are the causes of trichiasis?
Most commonly a long-standing inflammatory condition of the eyelid such as blepharitis results in trichiasis. Infections, certain eye drops, trauma or surgery may also be the cause.
What are the symptoms of trichiasis?
Symptoms typically include sore, red and watery eyes with a constant feeling of something in the eye.
Can trichiasis affect the eye or eyesight?
Long-standing irritation by the ingrowing eyelashes can sometimes lead to damage to the front of the eye (the ‘cornea) and this can lead to infections and scarring which can affect sight.
How is trichiasis treated?
The underlying cause should be treated. The offending lashes may be epilated/pulled out which gives temporary relief for several weeks until they regrow. Eye lubricants can protect the eye against the lashes, the thicker the better.
More permanent options include electrolysis, cryotherapy and surgery. All of these are performed under local anaesthetic.
Electrolysis aims to destroy the eyelash follicles individually and is suitable if there are only a few offending lashes. In order to know where to treat, the eyelashes must not be plucked beforehand. Although recurrence is not uncommon the treatment can be repeated.
Cryotherapy aims to destroy an area of eyelashes follicles and is suitable if there are widespread offending eyelashes. There can be significant pain and swelling after cryotherapy and a risk of depigmentation of the skin and/or a change of the contour of the eyelid.
Surgery aims to excise the eyelash follicles and is suitable is there are a few eyelash follicles that need definite treatment or if there are many offending lashes clustered together. Again the contour of the eyelid may be changed.