Trichiasis

Trichiasis is an uncornfortable condition in which the eyelashes are misdirected toward the eyeball and scratch its surface, the cornea. The position of the lower lid is normal, but the lashes point in the wrong direction. This may cause infection and scarring of the cornea.

The most common cause is chronic inflammation with scarring in the lower lid. Such scarring can occur from lid infections, skin diseases, or from trauma and poor healing of the lid tissues.

TREATMENT by removal of the lashes is frustrating, because within a few weeks the lashes return to irritate the eye.  Removal does provide temporary relief, however. Permanent destruction of the lash follicle is the only sure way to prevent recurrences. This can be done by one of the following methods:

The first is electrolysis. Here an electric current is passed through the base of the lash in hopes of killing the cells that produce the hair. Recurrence rates are very high, and scarring can be a problem.

The second is a newer method called cryosurgery. Here a general area is frozen with an appropriate instrument, thus disturbing the micro-circulation and thereby killing the hair follicles. Recurrence rates with cryosurgery are much lower than with electrolysis. Re-freezing is only occasionally necessary. Ordinarily, no local anesthetic is used. The lid does swell within a few minutes and sometimes forms a blister. Oozing is common for several days after the procedure. With time, the lid returns to an almost normal appearance, without the offending lashes.

An even newer method is now being investigated, in which the offending lashes are treated with an Argon LASER to destroy the hair follicle. Early results are positive, but more work needs to be done to make sure this treatment is well tolerated and safe.