Trichiasis: Inverted Eyelashes

Featured article image of the eye.

Trichiasis is basically the clinical term for ingrown eyelashes.

The term comes from the ancient Greek word for hair. It is a condition in which the eyelashes grow inward toward the eye. These ingrowing eyelashes rub against the cornea and the inner surfaces of the eye and cause irritation.

Causes

In some instances there is no known cause. In other cases, trichiasis is caused by an eye infection, inflammation of the eyelid (blepharitis), an autoimmune disease, or trauma to the eye. And in some cases, there is an extra row of eyelashes that develop and grow toward the eye. That condition is called distichiasis.

Symptoms of Trichiasis

Sore, red, and itchy eyes that may be watery and blurry vision due to the irritation.  You can treat the symptoms of pain and irritation with over-the-counter artificial tears and warm compresses to the eye, but these remedies will only temporarily relieve the symptoms. They won’t treat the problem. For that you need eyelash removal.

Risks of Developing Trichiasis

  • Epiblepharon, is a disorder that causes loose skin around the eye to form a fold and cause the lashes to grow in a vertical position. It is mostly found in people of Asian ancestry. It can also occur due to muscle and tissue weakness or from an infection or injury.
  • Herpes zoster eye disease.
  • Trauma to the eye such as burns.
  • Chronic blepharitis in which oily particles and bacteria coat the lid margin near the base of the eyelashes.
  • Trachoma, a severe eye infection found in developing nations.
  • Rare disorders of the skin and mucous membranes such as Stevens-Johnson syndrome and cicatricial pemphigoid.

Removing ingrown eyelashes

If you only have a few ingrown eyelashes, you can pluck them yourself, but they may grow back in a few weeks. Surgery to remove the eyelashes at the root will usually stop regrowth.

There are four types of surgeries that can be used:

  • Ablation surgery uses radio frequencies or lasers to remove the lashes and their hair follicles.
  • Electrolysis uses electricity to permanently remove the lashes. This surgery is effective but can be time-consuming and painful.
  • Repositioning surgery repositions an eyelid and its eyelashes. 
  • Cryosurgery removes the eyelashes by freezing them. This surgery is effective but has a potential for complications, such as edema, necrosis, loss of skin pigmentation, damage to the meibomian glands and loss of goblet cell function.

Gregory Scimeca, M.D.
Ophthalmologist and Medical Director