Eyelid – Trichiasis

What is trichiasis?

Trichiasis describes eyelashes which are mis-directed towards the eyeball, and should not be confused with entropion, in which the eyelid itself is rolled inwards. This is an important distinction, as the treatment for the two conditions is not the same.

What are the causes of trichiasis?

Any chronic inflammation of the eyelid, in particular trachoma, may result in trichiasis.

What are the symptoms of trichiasis?

The symptoms depend on the degree of trichiasis, but typically include irritable, sore and watery eyes.

Can trichiasis affect the eye, or eyesight?

Chronic irritation of the eye by aberrant eyelash(es)can lead to localised erosions and ulceration of the ocular surface, and this carries a risk to the eyesight.

How is trichiasis treated?

Once entropion and other eyelid and conjunctival disease has been excluded, the aberrant lashes may either be epilated (removed), giving temporary relief for several weeks, or treated more permanently by electrical treatment to the roots of the lashes (electrolysis). The latter is performed under local anaesthetic and takes about 15 – 30 minutes. Following electrolysis, the eye may be padded for a few hours, and antibiotic drops are prescribed. A review is organised for a few weeks later to determine whether there are any persistent or new lashes, which not infrequently occurs. For more extensive areas of trichiasis, freezing treatment (cryotherapy) can also be used, but this carries a risk of lid scarring and distortion and is used only in severe, selected cases.