Trichiasis: Misdirected Eyelashes

Are Your Lashes Poking You in the Eye?

Does it feel like your eyelashes are poking you in the eye? Chances are, they very well may be. A misdirected eyelash can feel like a sharp object sticking into your eye. Trichiasis is a common eyelash problem that causes eyelashes to grow abnormally. Instead of growing outward, a few eyelashes may grow inward toward the eye. Because eyelashes are often very coarse, trichiasis can feel like a needle poking into your eye.

Trichiasis often causes pain and irritation, but it can also cause damage to your eye.

Symptoms of Trichiasis

Trichiasis can cause your eyelashes to rub against the conjunctiva and the cornea, causing pain and irritation. The constant irritation to the cornea can sometimes cause a corneal abrasion. Inflammation and vision loss can also occur if the condition becomes chronic or ongoing. People with trichiasis often complain of the following symptoms:

  • Foreign body sensation
  • Eye redness
  • Blurry vision
  • Watery eyes
  • Eye pain

Inflammation and vision loss can also occur if the condition becomes chronic or ongoing. People with trichiasis often complain of something scratching their eye or they think that there is a piece of sand in their eye. Because the eyelashes are very course, they can do a lot of damage to the surface of the cornea. Trichiasis can also cause tremendous pain, tearing and blurry vision.

Causes of Trichiasis

Sometimes doctors do not find a reason why the eyelashes grow the wrong way. This is called an idiopathic cause. The eye appears healthy, but the eyelash just tend to grown inward.  A very common cause of trichiasis is blepharitis. Blepharitis causes infection and inflammation of the eyelids and and eyelid margin.

When this occurs, the hair follicles can become misdirected and cause annoying trichiasis. In certain individuals, the eyelid tissue because floppy. This is sometimes due to age or being over weight. is seen more commonly in adults, although anyone can develop the bothersome disorder. Trichiasis is sometimes caused by a simple eye infection, inflammation of the eyelid, autoimmune conditions and trauma. Many cases of trichiasis are seen after a bout with blepharitis, a condition that affects the eyelids and eyelashes. 

Following are a few eye conditions that may cause the eyelashes to be misdirected or grow abnormally:

  • Entropion: The eyelid looses its normal elasticity and flips or folds inward.
  • Blepharitis: Blepharitis is a common eyelid infection and inflammation of the eyelids and lashes.
  • Injury: If the eyelid is torn or injured, the position of the eyelashes may change and grow inward. This can happen as a result of the surgical repair of an injured eyelid.
  • Distichiasis: An extra row of eyelashes develops and grows inward, rubbing against the eye.
  • Idiopathic: Occasionally, an eyelash will simply grow or bend in the wrong direction.

Diagnosis of Trichiasis

The irritation caused by trichiasis is usually enough to prompt a person to make an appointment with an eye doctor.

By examining your eye with a slit lamp, your eye doctor will be able to tell if you are in fact  suffering from trichiasis. The doctor may find a few of your eyelashes are growing inward toward your eyeball, and some of them may even be brushing against the surface. Your doctor will also instill a staining solution to show potential damage that may have occurred to your cornea due to the repeated irritation. This test can reveal how serious your condition may be. 

Treatment of Trichiasis

The following options may be used to treat trichiasis. Your doctor will decide which treatment option is best for you.

If the initial treatment your doctor chooses is not sufficient, he or she may decide to explore other treatment options in this list. 

  • Epilation: The first line of treatment is to epilate or pluck the misaligned or misdirected lashes with special forceps. Eyelashes will typically grow back in 2 or 3 months.
  • Electrolysis: Electrolysis uses an electric current to damage the hair follicle preventing re-growth. Reoccurence occurs in 40-50% of patients.
  • Radio Frequency: Radio frequency devices kill the hair follicle to prevent re-growth.
  • Surgery: In severe cases, eyelid surgery may be performed to eliminate trichiasis.
  • Bandage contact lens: A soft bandage contact lens is applied to the cornea to help the corneal heal and to protect it from eyelashses that have not been epilated yet.

What You Should Know

If left untreated, trichiasis can turn into a serious eye problem. A corneal abrasion, which may develop from a coarse eyelash, can cause considerable damage to your eye. If an infection occurs, your doctor may prescribe antibiotic eye drops and anti-inflammatory medicines. Frequent visits are also recommended. They life cycle of an eyelash is around 3 months. If you have trichiasis that is recurrent, schedule your doctor visits every two and a half months so that the doctor can check to see if any new eyelashes are growing the wrong way. It may require a lot of office visits but that is a whole lot better than winding up with a bad case of trichiasis on the weekend and being in pain for a few days. If you suspect trichiasis, be sure to seek the advice of a professional.


Catania, Louis J. Primary Care of the Anterior Segment, Second Edition. Appleton & Lange, 1995.


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