Trichiasis is a common eyelash problem that causes eyelashes to grow abnormally. Instead of growing outward, a few eyelashes may grow inward toward the eye. Because eyelashes are often very coarse, trichiasis can feel like a needle poking into your eye and that often causes pain and irritation—but it can also cause damage to your eye if not resolved.
Symptoms of Trichiasis
Trichiasis can cause your eyelashes to rub against the conjunctiva and the cornea, causing pain and irritation. The constant irritation to the cornea can sometimes cause a corneal abrasion. Inflammation and vision loss can also occur if the condition becomes chronic or ongoing.
People with trichiasis often complain of the following symptoms:1
Foreign body sensation
Eye redness
Blurry vision
Watery eyes
Eye pain
Many say they feel like something is scratching their eye or they think that there is a piece of sand in their eye.
Contact your eye healthcare provider when you feel eye irritation, as a corneal abrasion or infection can develop.
Causes
Sometimes healthcare providers do not find a reason why the eyelashes grow the wrong way. This is called an idiopathic cause. The eye appears healthy, but the eyelash just tends to grow inward.
However, a very common cause of trichiasis is blepharitis. Blepharitis causes infection and inflammation of the eyelids and eyelid margin. When this occurs, the hair follicles can become misdirected and cause trichiasis.
There are a few other eye conditions that may cause the eyelashes to be misdirected or grow abnormally:2
Entropion: The eyelid loses its normal elasticity and flips or folds inward. This is sometimes due to age or being overweight. It is seen more commonly in adults.
Injury: If the eyelid is torn or injured, the position of the eyelashes may change and grow inward. This can happen as a result of the surgical repair of an injured eyelid.
Distichiasis: An extra row of eyelashes develops and grows inward, rubbing against the eye.3
Treatment Options
The following options may be used to treat trichiasis. Your healthcare provider will decide which treatment option is best for you. If the initial treatment your healthcare provider chooses is not sufficient, they may decide to explore other treatment options on this list.
Epilation: The first line of treatment is to epilate or pluck the misaligned or misdirected lashes with special forceps. Eyelashes will typically grow back in two or three months.
Electrolysis: Electrolysis uses an electric current to damage the hair follicle, preventing re-growth. Recurrence occurs in 40% to 50% of patients.
Surgery: In severe cases, eyelid surgery may be performed to eliminate trichiasis.1
Bandage contact lens: A soft bandage contact lens is applied to the cornea to help it heal and to protect it from eyelashes that have not been epilated yet.3
Frequent visits to your eye healthcare provider are recommended when you have trichiasis. The life cycle of an eyelash is around three months. If you have trichiasis that is recurrent, schedule your healthcare provider visits every two and a half months so that the healthcare provider can check to see if any new eyelashes are growing the wrong way.
