What Is Trichiasis?

Trichiasis is a common eyelid problem. Eyelashes grow inwards toward the eye. The lashes rub against the cornea, the conjunctiva, and the inner surface of the eyelids. This irritates the eye.

What Causes Trichiasis?

Sometimes people get trichiasis and there is no known cause. Anyone can develop trichiasis. It is more common in adults. Some causes of trichiasis include:

• eye infection
• inflammation (swelling) of the eyelid
• autoimmune conditions
• trauma

Certain conditions increase your risk of developing trichiasis:

• Epiblepharon. This is congenital disorder in which the eyelid rolls slightly inward and the lashes assume a vertical position. The lashes may brush against the cornea. This is mostly found in children of Asian ancestry.
• Herpes zoster eye disease.
• Trauma to the eye, such as burns.
• Chronic blepharitis. This is a common and ongoing condition. The eyelids become swollen. Oily particles and bacteria coat the lid margin near the base of the eyelashes.
• Trachoma. This is a severe eye infection found in developing nations.
• Rare disorders of the skin and mucous membranes. (Stevens-Johnson syndrome and cicatricial pemphigoid)

Trichiasis Symptoms

Your eye may feel irritated by the sensation of having something in your eye.

Other symptoms include:

• redness
• tearing, and
• sensitivity to bright light

Eyelashes that rub against the cornea for a long time can cause a corneal abrasion or even a corneal ulcer.

How Is Trichiasis Treated?

Trichiasis treatment involves removing the eyelash, follicle or both, or redirecting eyelash growth.

Sometimes trichiasis affects only a few eyelashes. Your ophthalmologist may simply remove them with forceps (tweezers). There is a chance the eyelashes may grow back again in the wrong direction.

If you have many lashes growing toward your eye, surgery can remove them permanently. Ablation surgery uses laser, radiofrequency, electricity or freezing to remove the lashes and hair follicles. Your ophthalmologist will numb your eye before the outpatient procedure.

Other surgical treatments include:

• Electrolysis. This process uses electricity to permanently remove hair. While effective, electrolysis is time-consuming, can be painful, and often needs to be repeated
• Cryosurgery. This removes the lashes and follicles by freezing them. Cryosurgery is effective but has the potential for complications and may need to be repeated.

Your ophthalmologist may recommend surgery to reposition the eyelashes. This can be the case if your trichiasis is due to epiblepharon or other type of turning inward of the eyelids (entropion).