What Is Trichiasis?

Trichiasis: refers to the abnormal condition that the eyelashes grow backwards so that they touch the eyeball. Trichiasis is a common external eye disease in children, adolescents, and the elderly, mainly due to abnormal growth of eyelashes. Eyelashes with abnormal growth directions, especially those growing backwards to the corneal surface, not only often rub the corneal epithelium, causing foreign body sensation, fear of light, tears and other symptoms, but also cause eye congestion, conjunctivitis, corneal epithelium shedding, keratitis, cornea Vascular ridges, corneal ulcers, and corneal leukoplakia affect vision.

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There are many causes of trichiasis. Children and adolescents are mainly due to the abnormal growth of eyelashes.

1. Trichiasis without eyelid inversion: simply due to abnormal growth of eyelashes, or

When checking the lower eyelids, ask the patient to look down to find out if the eyelashes touch the cornea.

Inflammation of the conjunctiva: Because the eyelashes repeatedly stimulate the conjunctiva and the cornea, conjunctivitis is more difficult to cure, often recurrent, and tears and secretions often appear. When conjunctival inflammation is recurrent and does not heal for a long time, some patients have conjunctival scars, and a few have local eyelid adhesions.

Changes in the cornea: Trichiasis can cause punctate or diffuse damage to the corneal epithelium, shedding of the corneal epithelium, superficial opacity of the cornea, corneal blood vessels, corneal epithelial keratosis, cornea

1. Double lashes (distichiasis): refers to a row or part of the eyelashes opening in the meibomian gland or slightly behind it. This kind of abnormal eyelashes are thinner or lack pigment.

2. Unusual eyelashes or metaplastic lashes: Eyelashes originate from the meibomian gland sac, the growth direction of the eyelashes is disordered, and the disease mostly occurs in long-term scar conjunctivitis.

Treatment of trichiasis for infants and children:

Because some infants are relatively fat, the nose is flat, and they are underdeveloped. In addition, some children have lower eyelid crusts or combined with condyle crusts, which can cause lower eyelid trichiasis or lower eyelid inversion. People can heal with age. Because the baby's eyelashes are generally small and soft, and the irritation symptoms are generally not obvious, surgical treatment can be considered when conservative treatment is ineffective, usually after the child is 3 years old. In some children, with age, the development of the bridge of the nose, congenital tarsal varus often disappears on its own. Generally, it is not rushing to surgery. It can often pluck its lower eyelid, and sometimes the lower eyelid can be covered with adhesive tape (but it has been rarely used, adhesive tape It can cause infants' delicate skin allergies, rashes or erosions). In addition, it can be used with anti-inflammatory eye drops and eye drops to promote corneal epithelial repair.

If the eyelashes are severely irritated to the cornea at the age of 5 to 6, and there are many tears, surgery can be considered. Younger children can use suture correction, which uses the force of suture to pull the edge of the eyelid outward. This method is simple, general anesthesia time is short, safe, but easy to relapse, some patients for months or months Relapse after years. If you are older and have severe varus, partial resection of the lower eyelid skin and orbicularis can be performed. This method has a high success rate and long-lasting effect, but you need to take a lower eyelid bag incision, or upper eyelid double eyelid incision. General anesthesia is slightly longer, and some patients will have scars on the lower eyelid after surgery, and some patients will have the appearance of double eyelids on the lower eyelid. The parents of most children are afraid of surgery and are more likely to undergo suture surgery as a stop-and-go measure to slow down trichiasis.

For adults with fewer trichiasis without eyelid inversion, the common treatment methods are as follows:

Removal method: When the number of trichiasis is small, it can be removed directly with eyelash tweezers, which is simple and effective, but because the hair follicles of the eyelashes are not damaged, it is easy to relapse within a few weeks. The eyelashes that grow again will be thicker and stiffer, irritating the cornea, so the removal is only necessary if the conditions are rough and there is no other way, or if other methods try to be ineffective.

Electrolytic method: electrolytic destruction of hair follicles and removal, sometimes it takes several times to achieve the desired effect, the success rate is about 10-20%.

Cryotherapy: It can relieve numerous trichiasis. Potential complications include: loss of pigment on the skin, postoperative eyelid notch, damage to meibomian glands, and impact on tear film stability.

Laser treatment: Laser separation is effective for a few scattered trichiasis.

Surgical removal of hair follicles under microscope: treatment of hair follicles under microscope; if there is a large number of trichiasis, wedge resection or anterior laminectomy can be used, which is effective for locally clustered trichiasis that cannot be treated by other methods.

(3) For patients with a large number of trichiasis and eyelid inversion, the commonly used surgical methods are as follows:

After the operation, the dressing was changed every other day, and the stitches were removed after 7 days. Eat less or fast foods such as spicy stimuli within one week after surgery. Pay attention to the cleanness of the surgical wound to avoid wound infection. The diet is based on nutrient-rich, easily digestible foods, and vitamin-rich vegetables and fruits to promote wound healing. Pay attention to rest and avoid fatigue. ^[1]

Trichiasis in children under 3 years of age, because the children's eyelashes are very soft, you can choose the timing of surgery based on the child's conscious symptoms and the degree of damage to the cornea and vision. If there is no damage to the cornea and vision, the trichiasis is relatively light, the subjective symptoms are not obvious, and it can be observed. You can visit your doctor regularly for 3 months or half a year for the doctor to assist in observation. If you experience sudden photophobia, tears, red eyes, and increased secretions, it may indicate that conjunctivitis may worsen, or corneal inflammation may occur. If the corneal damage caused by trichiasis is more serious, general anesthesia surgery can be considered. For adult patients with trichiasis, if surgical treatment is not effective, surgical treatment can be considered. The main problems that may occur after surgical treatment: the problem of recurrence of trichiasis, the problem of skin scars on the eyelids, and the appearance of "double eyelids" that affect the appearance of the lower eyelid. These problems are possible. But with the development of technology, modern trichiasis correction technology will control these problems to the smallest extent possible. Eyelid skin scars usually fade or disappear after 3 to 6 months. Generally, after 3 months of surgery, the eyelid skin and tissues gradually swell and slowly return to nature.