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Trichiasis: Misdirected Eyelashes

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Updated October 07, 2010

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

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 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.

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. 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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