The harms of trichiasis

Written by Zheng Xin

Ophthalmology

Updated on September 14, 2024

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Trichiasis refers to the condition where eyelashes grow backward and irritate the eyeball. There are many causes of trichiasis, including eye injuries such as burns which can lead to scar formation and subsequently scarring trichiasis. Other causes include blepharitis and meibomian gland dysfunction. The harm posed by trichiasis is significant; the misdirected growth of eyelashes towards the eyeball and their constant friction can lead to conjunctival congestion, corneal opacity, ingrowth of new blood vessels into the cornea, and potentially result in keratitis and corneal ulcers.

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How to deal with inverted eyelashes

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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Ophthalmology

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Will the inverted eyelashes grow back after being plucked?

Trichiasis, if plucked, can still regrow, and the new eyelashes may be harder than before, posing a more severe irritation to the conjunctiva and cornea of the eye, so plucking is not recommended. If there are few lashes, electrolysis of the eyelashes can be performed; if there are many, surgery can correct the trichiasis. Once trichiasis occurs, local anti-inflammatory eye drops should be used, such as levofloxacin eye drops, gatifloxacin eye drops, and eye ointment. Use tobramycin eye ointment and erythromycin eye ointment; do not apply heat, take rest, eat a light diet, reduce close work, have regular check-ups, and monitor your vision. (Please use medications under the guidance of a physician.)

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Can I pluck an inverted eyelash myself?

It is best not to pluck ingrown eyelashes yourself, as they will grow back even harder than before, and will grow irregularly in multiple directions instead of just outward. This will cause the eyelashes to grow disorderly. Ingrown eyelashes generally cause abrasion to the conjunctiva and cornea. If there are few ingrown eyelashes, treatment can be done by propping them up; if there are many, surgical treatment can be considered. To protect the corneal epithelium from ingrown eyelashes, certain eye drops like sodium hyaluronate may be used, along with anti-inflammatory eye drops like levofloxacin. With active treatment, recovery is usually complete. If not properly treated, it could gradually lead to corneal diseases, severely affecting vision.

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Can inverted eyelashes be fixed with an eyelash curler?

In general, it is not advisable to pluck inverted eyelashes with tweezers, as the more you pluck, the thicker the inverted eyelashes become, making them more likely to injure the cornea and conjunctiva. This means the eyelashes become harder, creating a vicious cycle. If you have inverted eyelashes, it’s important to actively treat the condition: if there are few eyelashes, electrolysis can be done; if there are many, corrective surgery for inverted eyelashes is recommended and generally effective. During the period of dealing with inverted eyelashes, you should use anti-inflammatory eye drops and eye drops that protect the corneal epithelium, such as Levofloxacin eye drops and Sodium Hyaluronate eye drops. It's important to rest, avoid rubbing your eyes with dirty hands, maintain a light diet, avoid spicy and irritating foods, and monitor your vision.

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Will there be scars after entropion surgery?

After the surgery for trichiasis, scars may remain in the eyelid area. However, because the skin on the eyelids has a strong healing ability, the scars usually are not conspicuous. Trichiasis is usually caused by a spasm in the orbicularis oculi muscle inside the eyelid, leading to entropion. Eyelashes poking toward the corneal tissue scratch the corneal epithelium with each blink, causing redness, eye pain, foreign body sensation, photophobia, and tearing. If not treated promptly, it can easily lead to keratitis and may form scars within the corneal tissue, reducing corneal transparency and thus affecting the patient’s vision. Treatment typically requires surgery to remove excess loose skin on the eyelids and to eliminate part of the spasmodic orbicularis oculi muscle, returning the eyelid to its normal position and alleviating the symptoms.