Trichiasis: Misdirected Eyelashes

Are Your Eyelashes Growing into Your Eye?

Does it feel like your eyelashes are poking you in the eye? Chances are, they very well may be.

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 and that often causes pain and irritation—but it can also cause damage to your eye if not resolved.

Symptoms

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

Many say they feel like something is scratching their eye or they think that there is a piece of sand in their eye.

Causes

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. 

However, a very common cause of trichiasis is blepharitis. Blepharitis causes infection and inflammation of the eyelids and eyelid margin. When this occurs, the hair follicles can become misdirected and cause trichiasis.

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

  • Entropion: The eyelid loses its normal elasticity and flips or folds inward. This is sometimes due to age or being overweight. It is seen more commonly in adults.
  • 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.

Diagnosis

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.

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 Options

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 on 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 two or three months.
  • Electrolysis: Electrolysis uses an electric current to damage the hair follicle, preventing re-growth. Recurrence occurs in 40 to 50 percent of patients.
  • Radio Frequency: Radio frequency devices kill the hair follicle to prevent regrowth.
  • 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 it heal and to protect it from eyelashes that have not been epilated yet.

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.

A Word From Verywell

Frequent visits to your eye doctor are recommended when you have trichiasis.

The life cycle of an eyelash is around three 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.

You may require a few office visits, but that much 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.

Source:

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

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