Distichiasis is a rare, sometimes hereditary condition in which an extra row of eyelashes is present in place of the meibomian gland orifices. Congenital distichiasis occurs when embryonic pilosebaceous units improperly differentiate into hair follicles (Fig 10-11). Treatment is indicated if the patient is symptomatic or if keratopathy develops. Lubricants and soft contact lenses may be sufficient; if not, electrolysis, radiofrequency ablation, and eyelid splitting with removal of the follicles are alternatives. Cryoepilation is used less often because of the risk of eyelid margin thinning or notching, eyelash loss, and skin hypopigmentation.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.