Trichiasis (ingrowing eyelashes)


What is trichiasis?
Trichiasis describes eyelashes that are misdirected towards the eye, and should not be confused with an entropion, in which the eyelid margin itself is rolled inwards against the eye. This is an important distinction, as the treatment for these eyelid problems is not the same.

What are the causes of trichiasis?
Any chronic inflammatory condition of the eyelid e.g. blepharitis, may result in trichiasis.

What are the symptoms of trichiasis?
The symptoms depend on the degree of trichiasis, but typically include irritable, sore, red and watery eyes with a constant foreign body sensation.

Can trichiasis affect the eye, or eyesight?
Chronic irritation of the eye by ingrowing eyelashes can lead to localised erosions and ulceration of the cornea (the normally clear “window” at the front of the eye), and this carries a risk to eyesight.


How is trichiasis treated?
Once an entropion and other eyelid and conjunctival diseases have been excluded, the aberrant lashes may either be epilated (pulled out), giving temporary relief for several weeks, or treated more permanently by electrical treatment to the roots of the lashes (electrolysis). This is performed under local anaesthesia and takes a few minutes. Following electrolysis, the eye may be padded for a few hours, and antibiotic drops or an ointment are prescribed. A review is organised a few weeks later to determine whether there are any persistent ingrowing eyelashes, 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 more severe cases.