What Is Trichiasis?

Trichiasis is a common eyelid abnormality in which the eyelashes are misdirected and grow inwards toward the eye.

Those inward-turning lashes rub against the cornea (the clear, dome-like window covering the colored iris and the pupil), the conjunctiva (the thin, clear membrane covering the sclera, which is the white part of the eye) and the inner surface of the eyelids, irritating the eye.

Trichiasis Causes

Anyone can develop trichiasis, although it is more common in adults. Trichiasis can be caused by an eye infection, inflammation (swelling) of the eyelid, autoimmune conditions and trauma.

Certain conditions increase your risk of developing trichiasis:

  • Epiblepharon, a congenital disorder that occurs when loose skin around the eye form a fold that causes the lashes to assume a vertical position. Epiblepharon is most commonly found in children of Asian ancestry.
  • Herpes zoster eye disease.
  • Trauma to the eye, such as burns.
  • Chronic blepharitis, a common and ongoing condition where the eyelids become inflamed (swollen), with oily particles and bacteria coating the eyelid margin near the base of the eyelashes.
  • Trachoma, a severe eye infection that is commonly found in developing nations.
  • Certain rare disorders of the skin and mucous membranes, including Stevens-Johnson syndrome and cicatricial pemphigoid.

Trichiasis Symptoms

If you have trichiasis, your eye may feel irritated by the sensation of having something in your eye. Other symptoms include redness, tearing and sensitivity to bright light.

Eyelashes that have been rubbing against the cornea for a long time can cause a corneal abrasion or even a corneal ulcer.

Trichiasis Treatment

Trichiasis treatment involves removing the eyelash, follicle or both, or redirecting eyelash growth.

If the trichiasis is limited to a single eyelash or just a few eyelashes, your ophthalmologist may remove the problem-causing lash with forceps. While this eliminates the immediate problem, there is a chance the eyelash may grow back again in the wrong direction.

If you have multiple lashes growing toward your eye, your ophthalmologist may recommend surgery to have them removed permanently. One surgery, called ablation, uses radiofrequencies or lasers to remove the lashes and hair follicles from which they grow. During the procedure, which is done in an outpatient setting, the eye is numbed.

Other surgical treatments include:

  • Electrolysis, a process that uses electricity to permanently remove hair. While effective, electrolysis is time-consuming and can be painful.
  • Cryosurgery, in which the lashes and follicles are removed by freezing. Cryosurgery is effective, but has the potential for many complications.


All information and images provided by: EyeSmart® a division of the American Academy™ of Ophthalmology

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