The term trichiasis describes the condition in which one’s eye lashes turn inwards. The resulting misdirection causes the lashes to scratch the eyeball. For anyone who has experienced this condition, it can be incredibly painful and irritating.
The eyelids normally have a single row of eyelashes on the upper and lower lids. There are on average one hundred and fifty lashes on the upper lid and seventy five on the lower lid. The lashes typically point outwards away from the eye. Eyelash follicles are normally deeper than a regular hair follicle.
Sometimes the lid margin can turn inwards causing one or more lashes to scratch the cornea (clear covering of the eye) or the conjunctiva (thin layer of clear tissue that covers the white of the eye). This will result in eye pain ranging from mild to moderate, redness, and excessive tearing. Most patients who suffer from this condition will experience several attacks per year.
What causes the lid margins to turn inwards? Aging is the most common cause since the skin loses its elasticity with age. Scarring due to mechanical trauma, chemical burns, previous eye lid surgery and ocular inflammation can also all cause the lid margins to curl towards the eyeball.
What can be done to treat trichiasis? Epilation or plucking the offending lashes is the most common technique used to provide immediate relief for patients who suffer from trichiasis. This involves anesthetizing the eyeball with anesthetic drops. The optometrist or ophthalmologist will then grasp the particular lash or lashes at its base with fine forceps and pull the lash out of its follicle. These lashes normally come out very easily with minimal discomfort to the patient. Artificial tear drops can be used for a couple days after the lashes are removed to provide further relief. New eyelashes will grow within the involved follicles and will likely point towards the eyeball again. Eyelashes grow to normal length in three to five months.
Alternatively, surgical techniques can be done as well to roll the lid margin outwards again. Additionally, laser treatments can be done directly on the particular eyelash follicles involved should a patient require lash removal several times per year.
Regardless of the technique used to treat trichiasis, providing a permanent treatment is extremely difficult. My best advice for patients who suffer from this condition is once you feel the expected symptoms of misdirected eyelashes, don’t delay consulting your optometrist or ophthalmologist to minimize your discomfort.