Trichiasis describes the situation where lashes rub against the cornea. This can involve both the upper and lower lids. This may occur where there is/are:

  • Aberrant lashes, which point the wrong way
  • Scarring conditions such as blepharitis, trachoma and others
  • Entropion which can turn the lashes against the cornea
  • Distichiasis, which usually runs in the family, where there is an extra row of lashes
  • Metaplastic lashes, are isolated lashes arising from the wrong spot on the lid which often point the wrong way

This is a child with epiblepharon, where there is extra muscle and skin in the lower lid, which rolls the lashes onto the cornea, causing irritation. The situation can be remedied by removing a small strip of skin and muscle.

When the lashes abrade the cornea there is irritation, redness and watering. The cornea can become infected resulting in keratitis, which is a potentially sight-threatening condition.

  • Epilation, lashes are individually plucked with epilation forceps (tweesers). The lash will usually come back but you may be lucky.
  • Electrocautery, the lash follicle is cauterized with a diathermy needle after a local anaesthetic has been given. This is a useful treatment for a few lashes.
  • Cryotherapy, is a freezing treatment, given after local anaesthetic, which stops the lashes from growing. It is suitable when there are many lashes involved.
  • Surgery may be require to re-position the eyelid.

Banner image: A normal set of eyelashes.