Trichiasis

definition

 Trichiasis refers to inward misdirection of cilia

(which rub against the eyeball) with normal position

of the lid margin.

 etiology

 Common causes of trichiasis include cicatrising trachoma,

spastic entropion, ulcerative blepharitis, healed

membranous conjunctivitis, hordeolum externum,

mechanical injuries, chemical burns, and operative scar on

the lid margin, destructive inflammations such as Stevens-

Johnson syndrome and diphtheria.

 Clinical symptoms

 Most commonly patients presents with foreign body

sensation and photophobia.

 Patient may also feel troublesome irritation, pain

and lacrimation.
 Clinical signs

 One or more misdirected cilia touching the cornea.

 Reflex blepharospasm and photophobia occur when

cornea is abraded.

 Conjunctiva may be congested.

 Signs of causative disease viz. trachoma, blepharitis etc.

may be present.
 complication

 Recurrent erosions, superficial opacities,

vascularization of the cornea and frequent, recurrent

corneal ulcers are eventually produced.

 Trichiasis may prevent corneal ulcers from healing

despite therapy, thereby threatening vision.

 Treatments

A few misdirected cilia may be treated by any of the following

methods:

 Epilation (mechanical removal with forceps) : It is a temporary

method, as recurrence occurs within 3-4 weeks. It must be repeated

every few weeks.

 Electrolysis : It is a method of destroying the lash follicle by electric

current.
 Diathermy : Destruction of the hair follicle.

 Cryoepilation: It is also an effective method of treating

trichiasis. Cryosurgery may be used to treat segmental
trichiasis, but can lead to necrosis and depigmentation of
the lid.
 Surgical correction: When many cilia are misdirected
operative treatment similar to cicatricial entropion
should be employed.