Trichiasis Treatment, Florida Eye Specialists and Cataract Institute

Eyelashes are meant to protect the eye, but sometimes they do the opposite. A common condition called trichiasis (or misdirected eyelashes or inverted lashes) can make a few lashes on either the upper or lower lid grow inward and continuously poke your eye. Since eyelashes are thick and rough, it can feel as though you’re being incessantly poked by a needle. 

Not only can this be painful and irritating, but the constant scratching and scraping could damage or scar your cornea (the clear covering of your eye). It could even cause a corneal ulcer or vision loss. Read on, and Florida Eye Specialists and Cataract Institute of Tampa Bay will help you understand exactly what trichiasis is.  

What Causes an Eyelash to Grow Inward? 

Sometimes inverted eyelashes are just “one of those things,” that have no clear cause. Other times, they can be caused by:  

• Heredity — Some people are born with misdirected lashes. Others develop it later in life. (Some breeds of dogs and cats are even prone to misdirected eyelashes!)  

• Injury — When scar tissue develops after an injury it can make eyelashes grow in the wrong direction. This can also happen after eye surgery.  

• Autoimmune disease  

• Distichiasis — Distichiasis is a rare condition in which an extra row of eyelashes sprouts and grows inward. These lashes are usually present at birth.  

• Herpes of the eye — If herpes infects the eye, the damage can cause inward-curling lashes.  

• Blepharitis — Blepharitis is a condition that causes bacteria and dandruff-like flakes to form at the base of your eyelashes.  

Entropion – Entropion is a condition in which the lower lid turns inward, causing eyelashes to constantly rub against the cornea. Entropion requires surgery in an operating room under local anesthetic. It can be caused by:  

— Aging – As you grow older, undereye muscles weaken and the tendons stretch. What are the most common causes of entropion?

— Inflammation – When your eyelids are inflamed, you may try to relieve the discomfort by rubbing your eyes or squeezing your lids shut. This can cause your eyelids to spasm and roll toward your eyes.  

— Previous surgeries or scarring – Scars from previous surgeries, burns or trauma can warp the eyeball’s normal curve.  

— Infection – Trachoma is an eye infection that causes inner-lid scarring. Inward-growing lashes are the final phase of trachoma. Trachoma is the most common infectious cause of blindness worldwide. It affects the poorest and most remote areas of 55 countries in Africa, Asia, Australia, the Middle East, and Central and South America. 

Africa is the most vulnerable continent, with 18 million cases of trachoma or 85 percent of all global cases. Each village in central Tanzania alone has between five and 20 people with reversed lashes caused by trachoma.  

— Congenital – Some children, primarily those of Asian descent, may be born with trichiasis. They may need to regularly use artificial teardrops to prevent corneal scarring. Often, they will outgrow it.  

What are the Symptoms of trichiasis? 

The condition has symptoms that don’t resolve on their own:  

• Feeling as though something is constantly in your eye.  

• Eyedrops don’t help.  

• Redness.  

• Itchy or watery eyes.  

• Sensitivity to light.  


Come to Florida Eye Specialists and Cataract Institute and one of our 18 highly skilled physicians will diagnose your condition by looking at your eyelids through a magnification microscope called a slitlamp. This analysis will let the doctor know whether or not you’re suffering from trichiasis. Sometimes, your eyelid may be scarred, making it difficult to see the inturned lashes during the initial examination. Next, he or she will moisten your eye with a staining liquid to see possible damage to your cornea. 

Treatments for trichiasis range from a simple office procedure to more drastic measures. Florida Eye Specialists and Cataract Institute can guide you to the procedure that’s right for you.  

• If the condition involves a single lash or only a few, first-line treatment is removal with forceps in your ophthalmologist’s office. (Don’t try this at home. You may scratch your eye.) Plucking is only a temporary solution because the lashes typically grow back to full length in three to five months. These lashes tend to be stiff and even more irritating.  

• When many lashes are growing toward your eye, you may need surgery to permanently remove them. Several procedures are available to relieve this problem.  

— Laser surgery – During laser surgery the eye is numbed and lasers are used to remove the lashes, as well as their roots (follicles). This is an outpatient procedure. The success rate of laser surgery is 57.9 percent after one session and 73.7 percent after a follow-up session.  

— Electrolysis – Electrolysis uses a high-frequency electrical current that damages follicles, preventing re-growth. It can be time-consuming and painful. Several sessions may be needed for this procedure, and recurrence happens in 30 percent to 50 percent of patients.  

— Radiofrequency surgery – Radiofrequency surgery uses radio waves to permanently destroy the lash’s root. This type of surgery is effective when you have only a few inverted lashes.  

However, if you have a small patch of these lashes, you may need to have surgery to address the issue. If a small patch of your lid is affected it may be better to have an operation to remove that part of the lid.  

— Cryosurgery – Cryosurgery removes eyelashes and their roots by freezing them. It’s an inexpensive procedure that’s considered to be the most effective treatment for removal of multiple lashes, with cure rates between 71 percent to 90 percent. Unfortunately, it may have severe complications.  

— Repositioning surgery – If your lashes are misdirected because your eyelid itself has turned inward, you may need surgery that addresses correcting the entire lid.  

What to Know About Inward-Growing Lashes

In 2010, there were an estimated 8.2 million people with this condition. Untreated, it can morph into a serious problem. Florida Eye Specialists and Cataract Institute would like to quell any fears you may have about surgery:  

• Surgery takes approximately 15 to 20 minutes per eye.  

• It doesn’t require general anesthesia.  

• Surgery may be a bit painful, but the pain isn’t indefinite. This is trivial compared to being in pain every day from lashes scratching your eye.  

• Surgery is only on the lid, not the eyeball.  

• You can go home one or two hours after surgery.  

• You can go back to work a day or two after surgery.  

Florida Eye Specialists and Cataract Institute suggests that you can take these proactive measures to reduce the chance of eye infection:  

• Wash your hands before putting in your contact lenses or taking them out. Bacterial infections can make lashes grow the wrong way.  

• Don’t use eyelash curlers. It’s easy to accidentally curl your lashes the wrong way. If you already have lashes that curl downward, this tool can aggravate the problem.  

• Skip the false eyelashes. False eyelashes stick to your lash line with gummy glue. This glue contains formaldehyde, which can invite allergic reactions. The heaviness of the glue can weigh down your eyelids, causing abnormal lash growth.  

• Clean your makeup brushes once a week with gentle soap and warm water. Then let them air dry. Dirty brushes can cause an infection, and the infection can make your lashes curl inward.  

• Never share makeup, no matter how enticing your friend’s eyeshadow looks.  

• Before going to bed, completely wash off your makeup with gentle soap and warm water. You can also use eye makeup remover wipes, which you can buy online or at a drugstore.  

A small eyelash can be a big problem if it’s pointed the wrong way. Trichiasis is a condition that’s not only painful and irritating but could lead to loss of vision. At Florida Eye Specialists and Cataract Institute, our job and our passion is to help correct misdirected lashes so that you can feel your best and enjoy your life. It’s clear to see, there’s only one choice in eye care.  

Please note that not all the information in this article will work for everyone and that this article is not a substitute for actual in-person medical treatment