What is trichiasis?

In trichiasis, the eyelashes point inwards towards the eye rather than outwards as normal. Rarely, the condition may run in families, so that babies may be born with it. Much more commonly it results from either entropion (turning in of the lower lid resulting from age-related slackness of the tissues) or long-standing inflammation of the eyelids which can cause abnormal eyelashes to grow out of the oil glands on the edge of the eyelid. 

In global terms the commonest cause of trichiasis is trachoma, an infection spread by flies and between people, which endangers the sight of at least 136 million people in 44 countries. Trachoma occurs throughout the world, but especially among people in developing countries and in poor rural communities. People with trichiasis usually have uncomfortable red eyes and a feeling of something in the eye. The optometrist will see that one or more lashes are in contact with the eye surface. This may cause damage to the eye surface, which can then become infected. 

How is trichiasis managed?

The optometrist may decide to pull out the offending lashes, using fine forceps. However, the lashes will usually grow again within four to six weeks, so this is only a temporary solution. Sometimes a bandage contact lens is fitted to relieve the patient’s symptoms. If the problem persists, the optometrist will refer the patient to the ophthalmologist, who may decide to remove the lashes by electrolysis, cryotherapy (freezing treatment) or laser treatment. If the cause is entropion, a minor surgical operation may be required.