What is trichiasis?
Trichiasis is an abnormal condition where the eyelashes grow inward and rub against the surface of the eye, usually the cornea or conjunctiva. This constant friction can cause irritation, burning sensations, and redness. If left untreated, trichiasis may lead to serious complications such as infections or corneal ulcers.
Unlike entropion, where the entire eyelid turns inward, in trichiasis the eyelid remains in its normal position, but the eyelashes grow in the wrong direction. It often affects only a few lashes but can also involve the entire eyelid.
Causes of trichiasis
Trichiasis can develop for various reasons. Sometimes it occurs without a clear cause, but it is often the result of another eye condition or trauma. Common causes include:
- Chronic blepharitis: Long-term eyelid inflammation can cause scarring, leading to misdirected lash growth.
- Trauma or injury: Burns, cuts, or other injuries to the eyelids may interfere with lash growth.
- Eye surgery: Surgical procedures can leave scar tissue that alters the direction of lash growth.
- Infections: Conditions such as trachoma, a bacterial infection common in developing regions, may damage eyelids and lashes.
- Autoimmune diseases: Disorders such as lupus or Stevens-Johnson syndrome can cause scarring of the eyelids.
- Aging: With age, the eyelids and lashes may lose their normal structure, increasing the risk of misdirected growth.
Symptoms of trichiasis
The symptoms depend on how many lashes are involved and how severe the condition is. Common symptoms include:
- Irritation, with a constant sensation of grit or sand in the eye
- Redness caused by ongoing lash friction
- Excessive tearing due to irritation
- Pain or discomfort, especially when blinking
- Light sensitivity (photophobia)
- Vision problems in severe cases, where lashes damage the cornea, leading to ulcers or scarring
Treatment options for trichiasis
Treatment depends on the severity and underlying cause. The main goal is to remove or redirect the misdirected lashes and protect the eye surface.
- Manual removal
In mild cases, an eye specialist may remove the ingrown lashes with fine forceps. This provides immediate relief, but lashes usually grow back, requiring repeated treatments. - Electrolysis
A fine electrical current is applied to the lash follicle to permanently destroy it. Several sessions may be needed for lasting results. - Laser treatment
A focused laser is used to destroy lash follicles and prevent regrowth. This method is precise and effective, especially for recurrent trichiasis. - Cryotherapy
This technique freezes the lash follicles with liquid nitrogen, permanently eliminating them. It is often used in severe or widespread cases. - Surgical correction
If trichiasis is due to scarring or eyelid deformities, surgery may be needed to reposition the lashes or eyelid.
Recovery and aftercare
Proper aftercare is essential to support healing and prevent complications:
- Eye drops: Artificial tears or prescribed medicated drops help keep the eye surface moist and reduce irritation.
- Eyelid hygiene: Good lid hygiene helps prevent inflammation, especially in people prone to blepharitis or infections.
- Regular check-ups: Since trichiasis often recurs, follow-up visits with an eye specialist are important.
Complications of untreated trichiasis
If not treated, trichiasis can cause long-term damage. The constant friction of lashes against the eye surface may lead to:
- Corneal ulcers, which may become infected and scar the cornea
- Corneal scarring, resulting in blurred vision or permanent visual impairment
- Eye infections due to increased susceptibility from ongoing irritation
Difference between trichiasis and entropion
While both conditions cause irritation and redness, they differ in origin. In entropion, the eyelid itself turns inward, bringing all lashes against the eye. In trichiasis, only the lashes grow inward while the eyelid remains in the correct position. Both conditions can damage the cornea but require different treatment approaches.
