Trichiasis: Misdirected Eyelashes

Trichiasis can cause constant tearing. Jonathan Knowles

Does it feel like your eyelashes are poking you in the eye? Trichiasis is a common eyelash problem that causes eyelashes to grow abnormally. Instead of growing out, the eyelashes grow inward toward the eye. Because eyelashes are often very coarse, trichiasis can feel like a needle poking into your eye. Trichiasis can cause pain and irritation, but it can also cause damage to your eye.

Symptoms of Trichiasis:

Trichiasis can cause the eyelashes to rub against the conjunctiva and the cornea, causing pain and irritation, and sometimes causes 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

Causes of Trichiasis:

Several eye conditions 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:

By examining your eye with a slit lamp, your eye doctor will be able to tell if you are suffering from trichiasis.

A few of your eyelashes will be growing inward toward your eyeball, and 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. This can reveal how serious the condition may be.

Treatment of Trichiasis:

The following treatments may be used to treat trichiasis:

  • 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 About Trichiasis:

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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