Electrolysis Trichitic Lashes

INTRODUCTION Trichiasis is an acquired condition in which the eyelash cilia are turned backward toward the globe. The lid margin is usually oriented normally with respect to the eye, but the lashes are directed at various angles. Trichiasis usually results from inflammation or scarring of the eyelid following eyelid surgery, trauma, chalazion, or severe blepharitis. It is frequently associated with chronic cicatricial diseases such as ocular pemphigoid, trachoma, and Stevens-Johnson syndrome.

CLINICAL PRESENTATION The eyelid margin may be normal in position, or it may be associated with entropion. The trichitic lashes arise from the normal lash row, but they are oriented backward towards the cornea. Patients complain of foreign body sensation and chronic ocular surface irritation. Corneal abrasion, conjunctival injection, mucoid discharge, and reflex epiphora are typical findings. In severe cases, frank corneal ulceration may be seen.

TREATMENT When only a few lashes are involved mechanical epilation will produce temporary relief.

Regrowth is usual within three to four weeks. A more permanent cure requires destruction of the offending lash follicles. This is achieved by direct bulb excision, electrolysis, or radiosurgery. When larger areas of the lid margin are involved, cryosurgery may be more effective and less destructive of the lid. Laser ablation of lash follicles has also been reported to be useful. In most cases retreatment is necessary over several sessions in order to completely eliminate the offending lashes. When entropion is also present, the lid margin should be corrected in addition to removing the trichitic lashes since skin against the cornea can also be damaging to corneal epithelium.

Epilation Trichiasis
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