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We had a lady who had had previous surgery on her eyelid for cancer, a basal cell carcinoma of the lower lid. After the surgery, she’s had a very good result, but some of the eyelashes (two or three of them) were now turning in against her eye and rubbing her eye. This is called trichiasis.
Trichiasis is the abnormal turning in of an eyelash, which can actually result from several different things; in this case, it was after a surgical procedure. It could happen after people get shingles around their eyes. Unfortunately, people get shingles involving their forehead and their eyelids, and the scarring from the shingles causes the lashes to be rotated or turned where it can grow in the eye, so that happens sometimes.
Occasionally, we see something that’s not really true trichiasis. Dr. Croley has seen an eyelash that came loose and lodged in the opening of the meibomian glands. You have meibomian glands along your lower lid—tiny, almost microscopic openings along the edge of the lid that secrete the outer oily layer to your tear film—and, amazingly, sometimes a lash goes in there, sticks, and rubs the eye. In that case, Dr. Croley will pull it out of the gland, and that’s the end of it.
When it’s true trichiasis, that won’t go away. You can’t just pull that out; you actually have to pluck it out of the hair follicle. You can do that, but if you keep plucking it out, it’s just going to keep growing back and sticking in the eye. Sometimes people’s eyelids roll in, and the lashes rub against the eye, but that’s not trichiasis; it’s called entropion of the lower lid.
So, what are the treatments? One, we could just pluck the lash out, but it’s going to come back.
Two, the most common thing we do is called electrolysis. For example, when you have facial hair or something and use electrolysis to remove that hair, we do the same thing with eyelashes. We inject the area of the lid where the lashes are growing to numb the eye, and then use a wire probe that goes down the eyelash follicle to cauterize it so the eyelash won’t grow back.
Before this was done very often, many years ago, we used to freeze the lid; we used a freezing probe on the eyelash area, let it thaw, and refreeze it to kill the hair follicle, but the swelling from that freezing was pretty painful, and we don’t do that very often. If you had a large number of them all the way across your lid, you might do that because it would take a long time to go with a little epilation to get those done. In most cases, we stick to the epilation for shorter recovery and because it works very well.
If you feel like there’s something scratching your eye, you could have dry eyes or trichiasis. There is treatment for both, so go see your eye doctor if you’re having that kind of problem.
If you have any questions about trichiasis or any other eye disease, contact the Cataract & Refractive Institute of Florida. If not, may God grant you healthy eyes and great vision.
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