Please note: Kliniek het Bolwerk does not carry out this treatment

Trichiasis is a medical eye condition in which eyelashes grow inwards and can irritate or damage the eye. Its assessment and treatment fall under regular medical care and are usually carried out by an ophthalmologist in hospital, often as part of insured care.

Kliniek het Bolwerk does not offer treatments for trichiasis. The information on this page is intended solely for general knowledge sharing and cannot replace a consultation with an ophthalmologist. For diagnosis, treatment and personal medical advice, please consult a hospital or eye specialist.

What is trichiasis?

Trichiasis is an abnormal growth of the eyelashes, in which they bend inwards and come into contact with the surface of the eye, usually the cornea or the conjunctiva. This can lead to constant irritation, a burning sensation and redness in the eye. In some cases, trichiasis can lead to serious complications, such as infections or corneal ulcers, if the eyelashes keep rubbing against the surface of the eye for a long time.

Unlike entropion, where the whole eyelid turns inwards, with trichiasis the eyelid stays in its normal position, but it is specifically the eyelashes that grow in the wrong direction. Although it is often a localised condition that affects only a few eyelashes, it can also affect the whole eyelid.

What are the causes of trichiasis?

Trichiasis can be caused by various factors. In some cases it develops spontaneously without a clear cause, while in other cases it is the result of an underlying eye condition or injury. Some common causes of trichiasis are:

Chronic blepharitis: Long-term inflammation of the eyelids (blepharitis) can cause scarring, which can make the eyelashes grow abnormally.
Trauma or injury: Injuries to the eye or eyelids, such as burns or cuts, can disrupt eyelash growth and lead to trichiasis.
Eye surgery: Sometimes eye surgery can cause scar tissue that affects the direction of the eyelashes.
Infections: Infections such as trachoma, a bacterial infection that is common in developing countries, can change the structure of the eyelids and eyelashes and cause trichiasis.
Autoimmune diseases: Certain autoimmune diseases, such as lupus or Stevens-Johnson syndrome, can cause scarring on the eyelids, leading to abnormal eyelash growth.
Ageing: As people get older, the eyelids and eyelashes can lose their normal shape, which can contribute to trichiasis.

Symptoms of trichiasis

The symptoms of trichiasis vary depending on the severity of the condition and how many eyelashes grow inwards. Some of the most common symptoms are:

Irritation: A constant feeling of something in the eye, such as grains of sand or dust.
Redness: The eye can become red due to the ongoing irritation of the eyelashes against the surface of the eye.
Watery eyes: The irritation can make the eyes water excessively.
Pain: Pain or discomfort, especially when blinking, is common because the eyelashes constantly rub against the surface of the eye.
Sensitivity to light: People with trichiasis can become sensitive to light (photophobia) as a result of the irritation and inflammation.
Visual problems: In severe cases, the constant friction of the eyelashes on the cornea can lead to damage, such as corneal ulcers or scarring, which can affect vision.

Treatment options for trichiasis

There are several treatment options for trichiasis, depending on the severity of the condition and the cause. The treatments focus on removing or correcting the misdirected eyelashes and preventing further damage to the surface of the eye.

1. Manual removal of eyelashes

In mild cases, the doctor can simply remove the inward-growing eyelashes by hand using tweezers. This provides immediate relief of the symptoms, but the eyelashes will grow back over time, so repeat treatments may be needed.

2. Electrolysis

Electrolysis is a procedure in which a small electric current is passed through the hair follicle of the eyelash to destroy it permanently. This prevents the eyelash from growing back. Electrolysis can be effective, but often requires several sessions for lasting results.

3. Laser treatment

In a laser treatment, a targeted laser is used to destroy the hair follicles so that the eyelashes cannot grow back. This is a precise method and is often used in cases of recurrent trichiasis.

4. Cryotherapy

Cryotherapy is a technique in which the hair follicles are frozen with liquid nitrogen to destroy them permanently. This can be used in severe or extensive cases of trichiasis.

5. Surgical correction

In some cases, a surgical procedure may be needed to correct the position of the eyelashes or the eyelid. This is especially useful if the trichiasis is caused by scarring or deformities of the eyelids.

Recovery and aftercare

After treatment of trichiasis, it is important to take good care of the eye to prevent complications and promote recovery. This may include:

Use of eye drops: Artificial tears or prescribed eye drops can help keep the surface of the eye moist and prevent further irritation.
Eye hygiene: Good eye hygiene is essential to prevent inflammation, especially in people who are prone to blepharitis or other eye infections.
Regular check-ups: Because trichiasis tends to come back, regular check-ups with an ophthalmologist are important to monitor the surface of the eye and eyelash growth.

Complications of untreated trichiasis

If trichiasis is not treated, it can lead to serious complications. The constant friction of the eyelashes against the surface of the eye can cause the following problems:

Corneal ulcers: The friction can cause small injuries to the cornea, which can develop into ulcers. This can lead to infections and scarring that can permanently damage vision.
Corneal scarring: Long-term irritation can lead to scarring on the cornea, which can result in blurred vision or lasting visual impairment.
Infections: The constant irritation can make the eye more susceptible to infections, which can cause further complications.

Difference between trichiasis and entropion

Although trichiasis and entropion can cause similar symptoms, such as irritation and redness of the eye, they are different conditions. With entropion, the eyelid turns inwards, causing the eyelashes to rub against the eye. Trichiasis, on the other hand, means that only the eyelashes grow inwards, while the eyelid itself stays in the correct position. Both conditions can lead to damage to the surface of the eye and require a different treatment approach.

Would you like to know whether eyelid surgery is suitable for you? Read more about the options on our page about eyelid surgery.