Hello and welcome to Case of the Day. I’m Dr Croley and today, we’re gonna discuss an interesting case that came in today. We had a lady who have had previous surgery on her eyelid for cancer, a basal cell carcinoma of the lower lid and then after the surgery she’s had a very good resolve. But some of the eyelashes, two or three eyelashes, were now turning in against her eye and rubbing her eye and this is actually called Trichiasis.
So Trichiasis is an abnormal turning in of an eyelash that can actually result from several different things. In this case, it was after a surgical procedure. It could happen after people get Shingles around their eyes. So sometimes unfortunately, people get Shingles involving their forehead and their eyelids and the scarring from Shingles causes the lashes to be rotated or turned where it can grow in the eye so that happens to some.
Well occasionally, we see something that’s not really true Trichiasis but actually I have seen an eyelash where it comes loose and the eyelashes actually sticking down in the opening of the Meibomian glands. You have Meibomian glands along your lower lid; tiny almost microscopic openings along the edge of the lid that secrete the outer oily layer to your tear film. And amazingly, sometimes a lash goes in there then sticks and then rubs the eye and in that case, all we have to do is pull it out of the gland and that’s the end of it. When it’s true Trichiasis, where the lashes are actually turning in and it’s a true eyelash, then that won’t go away, you can’t just pull that out. You actually have to pluck it out of the their follicle. You can do that but if you keep plucking it out, it’s just gonna keep growing back and stick in the eye.
Sometimes people’s eyelids roll in, and the lashes rub on the eye but that’s not really Trichiasis, that’s called Entropion of the lower lid. So, what are the treatments? The treatments for this, because it’s very irritating to your eye. The treatment is, one, we can just pluck the lash out but it’s gonna come back. Or, two, the most common thing we do anymore is called Electrolysis.
So just like you would have a facial hair or something, you could have Electrolysis to remove that hair. We do the same thing with eyelashes. So we inject the area of the lid where the lashes are growing in to numb up their eye, and then there’s a little wire probe that goes down in the eyelash down in the follicle. Then we step on the pedal and then we cauterize that follicle so that way, it kills it so it will not grow back.
Before this was done, very often many many years ago, we use to freeze the lid. So then we would put our freezing probe to the eyelashes area to freeze it, let it thaw, refreeze it and that would kill the hair follicle. But the swelling from the freezing was pretty painful and we don’t really do that very often. If the whole large number of them all the way across your lid, in that case you might do that because it would take a long time to go with a little epilation to get those done. But in most cases, we stick to the epilation because it’s very little recovery and it works very well.
So, if your eye feels like there’s something scratching your eyes, or something like that going on, you could have dry eyes, but you also could have Trichiasis where the lashes are rubbing your eye. There is treatment for it, so certainly go see your eye doctor if you’re having that kind of problem and there’s like options, we’ve discussed the options we went through. If you have questions about Trichiasis or any other eye disease, you can always try to contact us through the website. If not, may God grant you with healthy eyes and great vision.