5 Things To Know About Trichiasis

by Feb 1, 2023

Trichiasis is the term for an eyelash that turns in toward the eye’s surface or is otherwise misdirected. This condition can result in significant symptoms including eye pain, feeling as if something is in the eye, and increased watery discharge from the eye. There are multiple options for treating trichiasis including epilating the lash or lashes that are misdirected, using radiofrequency to deaden the lash follicle, or using a hard contact lens to protect the front of the eye from damage.

Normal Eyelash Growth

In a healthy eye, the eyelashes will grow in a uniform pattern that directs away from the front of the eye.

Both the upper and lower lashes will have a slight curl outward naturally to act as a defensive mechanism and prevent harm to the eye when the eyes are closed.

Lashes should grow in a uniform pattern and length. There should not be lashes that are significantly different in length from others including being shorter or longer than the rest of the lashes.

Symptoms of Trichiasis

Trichiasis is rarely asymptomatic, usually, there will be symptoms as soon as the lash is misdirected enough to contact the front of the eye.

The eye is extremely sensitive to pain from contact with the cornea and a lash that contacts the cornea will stimulate multiple pain sensors.

The feeling may develop that there is actually something in or on the front of the eye if the trichiasis is longstanding because the lash has created an area of damage that persists even when the lash itself is removed such as during a blink.

Since the eye is subjected to significant damage and pain, there will be an increase in reflex tearing. This increase can be so much that the tears actually pour over the lower lid and run down the cheek.

Most of the time, the eyelash that is deviated from the others will also be visible when inspected closely and may appear to be going in the wrong direction.

Complications from Trichiasis

While trichiasis and the symptoms it causes are enough to warrant treatment and intervention, there are also potential complications from the condition.

The biggest concern and risk is the development of a corneal ulcer from damage to the cornea. The prolonged damage may lead to a weaker cornea that is susceptible to infection.

Another concern is the increased risk of recurrent corneal erosions even after the treatment for the lash has been completed.

How is Trichiasis Treated?

The most common treatment for trichiasis is lash epilation. This means that the eyelash that is misdirected towards the cornea is removed with forceps and the lash and follicle are removed.

If epilation has been performed multiple times and the eyelash continues to grow into the cornea, radiofrequency can be used to deaden the lash follicle and prevent future lash growth. This is not a first-line treatment but is used when recurrent cases of trichiasis occur.

If the lash cannot be effectively treated, a protective contact lens can be placed on the eye. This contact is a large hard lens that prevents damage to the cornea and removes the possibility of pain and watering.


Our eye doctors at Perception Eyecare + Eyewear in Richardson, TX excel in the prescription of contact lenses, glasses and various eye diseases.  Call our optometrists at 972-250-0700 or schedule an appointment online if you would like to learn more about trichiasis.  Our optometrists provide the highest quality optometry services and eye exams in Richardson, TX and the surrounding vicinities of Garland, University Park, Sachse, and Highland Park.

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