Updated: 2018, Jun 12

Are You Suffering From Trichiasis?

By - Reviewed by CHD Team

What is Trichiasis?

Trichiasis is a condtion wherein the eyelashes instead of curling towards the outside of the eye, end up growing back towards it causing the eyelashes to touch the insides of the eye such as the cornea. This results to the eye becoming infected or inflamed.

The symptoms of trichiasis are constant eye irritation, pain in the eyes, sensitivity to the light, redness and excessive tearing up of the eyes.

What are the Main Causes of Trichiasis?


Trichiasis is usually caused by an infection or inflammation of the eyelid. It could also stem from an autoimmune disease which means that the body sees your healthy cells as foreign and ends up attacking these healthy cells.

According to the American Autoimmune Related Diseases Association, autoimmune diseases affect up to 50 million Americans. Trichiasis can also be triggered by a trauma such as burns.

Other conditions that may increase your risk of trichiasis are epiblepharon which is an inborn disorder which causes skin around the eye to become loose which in turn causes the lashes to abnormally grow. Blepharitis, is a common disorder that occurs when the oil in the glands in the eye area malfunction causing an infection, it may also lead to trichiasis if it is chronic. Trachoma, Stevens-Johnson syndrome and cicatricial pemphigoid may also have trichiasis as a side effect.

It seems that the history of the patient would be of help in the diagnosis of trichiasis. In order to properly treat trichiasis it is important the doctor must first know whether or not the trichiasis stems from a more serious and underlying condition.

For example, the fact that the patient is of Asian ancestry could be a sign that it is a case of epiblepharon. If the patient has ever had a severe eye infection or if he resides or has ever been to Africa or the Middle East could be red flags showing that the patient also suffers from Trachoma.

Also in cases where a patient is a burn survivor, it is suffer that he or she is suffering trichiases by reason of that trauma. Through these questions, it becomes easier to figure out what kind of treatment is best for the situation at hand.

Can we Deal with it Naturally or is There a Need to Undergo Surgery?

Undergo Surgery

In general, there is a need to have trichiasis surgically fixed. However, in mild cases, plucking and lubrication may help ease the irritation of the eye. The problem is artificial tears, ointments and plucking using forceps are merely temporary remedies. This means that trichiasis may still reoccur since the growth of the eyelash is the problem.

However new studies according to West and colleagues have shown that the use of azithromycin reduces the chances of trichiasis of reoccurring.

A study published online in Public Library of Science Medicine in 2011 lead by Saul Rajak, PhD from the London School of Hygiene and Tropical Medicine in the United Kingdom has found that patients treated with self epilation established that the treatment failed 13.2% of the time as compared to the 2.2% failure rate of patients who sought surgical help.

For trichiasis caused by serious illnesses such as Stevens-Johnson syndrome and cicatricial pemphigoid, immediate surgical attention must be given to the person affected.

What is the Treatment for It?

As was mentioned, plucking or epilation of the hair and lubrication using ointments and artificial tears can temporarily give relief to the patient. The problem is the lashes can grow right back and the same symptoms (irritation and inflammation) will only reoccur.

The best treatment would be to request an appointment with your doctor so that you may finally be alleviated of the hassles that come with having trichiasis. Lash and follicle repositioning surgery would be the best bet.

In this procedure, the surgeon seeks to fix the anatomical problem. Entropion and Posterior lamellar scarring are also options that are related to lash and follicle reporitioning.

It is important to note however that in cases where the trichiasis was triggered by a diagnosis of cicatrical pemphigoid, repositioning of the anterior lamellae would be the best choice since in other procedures, surgery of the conjunctiva may trigger the cicatrical pemphigoid. The reporitioning of the anterior lamellae does not disturb the conjunctiva and avoids any complications in this case.

What are the Precautions?

The best way to avoid trichiasis is by always being fully informed. Trichiasis, when left alone has the potential to become a serious condition since it would be threatening to the health of the eyes. By always being aware of the symptoms of trichiasis one can avoid the detrimental side effects to eyes.

Even if all you have is a simple case of blepharitis, once it is chronic and reoccurring, then that could be a more serious case of trichiasis. If you think that you have any of the symptoms above mentioned then it is best to get immediate medical attention to avoid any further irritation to the eyes.

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