How to deal with inverted eyelashes

Written by Li Zhuo
Ophthalmology
Updated on September 29, 2024
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For trichiasis, it first depends on the nature of the ingrown eyelashes. If there are only a few, such as one or two, it is recommended to pluck them out. For some people, once these are plucked, the new eyelashes may grow back in the correct position, so no further treatment is necessary.

If the ingrown eyelashes recur repeatedly as individual lashes, electrolysis of the hair follicle can be performed to destroy the follicle, preventing the eyelashes from growing back. However, because this is a destructive procedure, many hospitals have discontinued it, though some still offer this treatment.

If there are many ingrown eyelashes, appearing in rows, the treatment depends on the position of the eyelid. Eyelash correction surgery may be necessary. Depending on the specific situation, excision of the tarsal plate to correct the trichiasis can be considered as well.

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Written by Tao Yuan
Ophthalmology
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Why did a trichiasis suddenly grow?

A sudden formation of an ingrown eyelash is usually due to chronic inflammation in the eyelid margin area, which causes abnormalities in the eyelash follicles. Consequently, the direction of the eyelash growth no longer points straight forward but instead grows toward the eyeball. As the eyeball moves and blinks, the eyelash rubs against the corneal epithelium, causing noticeable symptoms such as a foreign body sensation, stabbing pain, congestion, redness, photophobia, tearing, and a decline in vision. One can visit the ophthalmology department of a hospital for a face-to-face examination and confirmation of the condition. Removing the ingrown eyelash can alleviate the symptoms, but recurrence is possible. If it recurs repeatedly, electrolysis treatment for ingrown eyelashes can be considered. This involves inserting a specially designed probe deep into the follicle of the ingrown eyelash and then passing an electric current through it. The electric current will destroy the follicle of the ingrown eyelash, making it less likely to recur.

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Written by Li Zhen Dong
Ophthalmology
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Can opening the eye corner cure trichiasis?

Trichiasis, if caused by epicanthus, can be corrected by canthoplasty. If it is not caused by epicanthus but by entropion of the eyelid, canthoplasty will not be effective. For trichiasis with few lashes involved, electrolysis can be used for treatment. If there are many lashes involved in trichiasis, entropion surgery can be performed. The surgery is minor and complete recovery is possible; usually, dressings are changed after surgery and recovery can be expected within about a week. If trichiasis severely wears down the cornea, active treatment should be sought to protect vision and the cornea.

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Written by Li Zhen Dong
Ophthalmology
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What will happen if trichiasis is not treated?

If trichiasis is not treated and allowed to progress, it can cause damage to the conjunctiva and the cornea. Particularly, corneal damage can lead to keratitis and corneal neovascularization, severely affecting vision and the transparency of the cornea. During treatment, if scarring occurs, such as thin corneal opacities, plaques, or leukomas, it can severely affect vision, and even lead to blindness. Therefore, while trichiasis itself is not severe, not treating it can lead to serious consequences. Currently, the main treatments for trichiasis include electrolysis of the eyelashes and surgical treatment, along with the use of eye drops, which generally results in a quick recovery.

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Written by Li Zhen Dong
Ophthalmology
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Can people with trichiasis wear contact lenses?

Patients with trichiasis often experience inflammation of the conjunctiva and the cornea, therefore, they cannot wear contact lenses. Once trichiasis occurs, it should be actively treated, especially targeting the trichiasis itself. If it is just a few eyelashes that are inverted, electrolysis of the eyelashes can be performed. If there are many eyelashes inverted, then surgical treatment should be considered. Once the condition stabilizes, contact lenses can be worn. However, since trichiasis affects corneal lesions, a corneal bandage lens can be worn to protect the cornea. Active treatment with eye drops and eye ointments is recommended, and hot compresses should be avoided.

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Written by Tao Yuan
Ophthalmology
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Is it better to open the eye corner for inverted eyelashes?

Patients cannot be cured of trichiasis by undergoing canthoplasty. Symptoms of trichiasis generally do not improve after canthoplasty, as trichiasis is usually caused by the abnormal growth direction of the eyelashes at the edge of the eyelid towards the cornea, or by spasm of the orbicularis oculi muscle, causing the eyelid edge to roll towards the eyeball. Trichiasis can injure the corneal tissue, leading to eye congestion, redness, foreign body sensation, pain, photophobia, and tearing. For a small amount of trichiasis, the lashes can be plucked with tweezers, but this often recurs. If trichiasis recurs frequently, electrolysis treatment can be performed to destroy the follicles growing the ingrown lashes, thereby minimizing recurrence. For a large amount of trichiasis caused by entropion, surgical treatment is needed to correct the entropion for a cure.