Trichiasis is a common eyelid problem. Eyelashes grow inwards toward the eye. The lashes rub against the cornea, the conjunctiva, and the inner surface of the eyelids. This irritates the eye. Symptoms may include a foreign body sensation, redness, tearing, pain, and sensitivity to bright light. Eyelashes that rub against the cornea for a long time can cause a corneal abrasion or even a corneal ulcer.
Sometimes people get trichiasis and there is no known cause. Some causes of trichiasis include eye infections or inflammation, autoimmune conditions, or trauma. An inward turning of the eyelid, called entropion, can be caused by natural aging or by scarring from trauma or burns. Epiblepharon is a congenital disorder characterized by loose skin around the eye, which forms a fold. This causes the lashes to assume a vertical position. This is mostly found in children of Asian ancestry. Chronic inflammation of the eyelid, such as blepharitis, can also lead to trichiasis.
Trichiasis treatment involves removing the eyelash, follicle or both, or redirecting eyelash growth. Sometimes trichiasis affects only a few eyelashes. Your eye doctor may simply remove them with forceps (tweezers). This is called epilation. There is a chance the eyelashes may grow back again in the wrong direction so this procedure may need to be repeated periodically.
Over the counter lubricants (Refresh®, TheraTears®, or Systane®) can reduce irritation associated with trichiasis. If an abrasion or significant inflammation are present, treatment with medicated drops or ointments may be required.
If you have many lashes growing toward your eye, surgery can remove them permanently. Specialized lasers can be used to remove the lashes and hair follicles. If trichiasis is caused by the eyelid turning inwards (entropion or epiblepharon), your eye doctor may recommend surgery to reposition the eyelashes. If this is needed you will be referred to an oculoplastic specialist.