Eyelash Problems (Trichiasis/Distichiasis)

What is Trichiasis

Trichiasis is a common eyelid abnormality in which the eyelashes grow inwards toward the eye. The inward-turning lashes rub against the cornea (eye surface) and the conjunctiva (the clear/pink lining of the eye) and the inner surface of the eyelids. This constant rubbing irritates the eye and can lead to a corneal abrasion or corneal ulcer (scratch or hole on the eye surface.)


What Causes Trichiasis

  • Entropion

  • Epiblepharon, a congenital disorder of the eyelids that causes the lashes to grow vertically

  • Herpes zoster ( Shingles) infection of the eye.

  • Trauma to the eyes such as burns.

  • Chronic Blepharitis

  • Trachoma, a severe eye infection that is commonly found in developing nations.

  • Certain rare disorders of the skin and mucous membranes, including Stevens-Johnson syndrome and cicatricial pemphigoid.


Symptoms of Trichiasis

  • Irritated sensation of the eye

  • Redness

  • Tearing

  • Sensitivity to light (due to corneal abrasion or ulcer)


Treatment of Trichiasis

If trichiasis is limited to a single eyelash or just a few eyelashes, your ophthalmologist may remove the problem-causing lash with forceps. While this eliminates the immediate problem, there is a chance the eyelash may grow back again in the wrong direction.

If you have multiple lashes growing toward your eye, your ophthalmologist may recommend surgery to have them removed permanently, using methods such as radiofrequency ablation, electrolysis and cryotherapy.


What is Distichiasis

This occurs when eyelashes grow on the inside of the eyelid at the opening of the Meibomian glands. It can either be genetic or acquired due to eyelid inflammation. It causes similar problems to trichiasis and is treated the same by removing the eyelashes.