As we age our eyelid looses its elasticity. Image Source RF/Marina Dyakonova

Definition: Trichiasis is a condition in which the eyelashes grow in the wrong direction. With trichiasis, the eyelashes become misdirected and grow toward the eye often causing a foreign body sensation, pain, redness, tearing, irritation and in extreme cases, vision loss.

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 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 otherwise 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.

The eyelid looses its elasticity and actually folds or flips inward toward the eye. This often happens easily when sleeping. The eye rubs against a pillow and easily flips inward. Another common cause of trichiasis is an 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. Finally, distichiasis can cause trichiasis. Distichiasis is the growth of an extra row of eyelashes and these commonly grown inward and rub against the eye.

Diagnosis of Trichiasi

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.

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.

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