Hello, I’m Dr. Croley and welcome to Case of the Day. Today we’re gonna discuss a patient who came in complaining that her eye was irritated and felt like something was scratching or rubbing her eye. And on exam it turns out that they had eyelashes that were turned in on the lower lid and rubbing her eye. And so that’s called Trichiasis – very common and happens as we get older. Usually this happens on the lower lid; very seldom that happen that the lashes on the upper lid turning in. On the rare occasion they do, but most of the time it’s on the lower lid.
So what happens is, in just a routine Trichiasis, there are muscles attached, tiny little muscles attached to your lashes that keep the lashes turned in the proper direction. So as we age, sometimes those muscles weaken and then they allow the lashes to turn back the opposite way. And so then as that rubs your eye, obviously the eye gets red and irritated and can lead to an infection.
Other causes of Trichiasis could be that, typically you have a scar on your lid such as a scar from getting Shingles or Herpes Zoster causes scarring of the lid. When the Singles occurs in the lid and this causes the lashes to grow on the wrong direction. If you had a stye or chalazion and the stye or chalazion cause the scar of your lid, then that could turn the lashes in as well. And other lesions as well could do that. And if you had a skin cancer or basal cell cancer or squamous cell cancer of the lid and that cause scarring after the surgery to where the lid, the lashes turn the wrong way, then that could also lead to Trichiasis.
So when someone has Trichiasis, their eyes are very irritated what do we do about. Well if the person, if there’s only one lash and the person was able to see it in maybe a high magnification mirror like you just pluck that lash out and that would be okay. If they are unable to see it or unable to do so, then we have a couple of different ways for we can treat Trichiasis. One is called Cryotherapy or freezing the area where the lashes are. So we put our freezing probe on that area of the lid and freeze that area and then let it thaw out and then freeze it the second time and that would kill the hair follicle and therefore the lashes would not grow in that part of the eyelid. A couple of disadvantages of that is that you’re also gonna kill the surrounding lashes because it’s gonna freeze an area. Also, it’s pretty painful afterwards to the swelling from the freezing treatment, can cause some pain so it’s a little bit painful.
And so, we typically, unless there’s a large area of where the lashes were turned in, do not use that system. The more common way of doing this is called Electrolysis. That’s the common thing we’ve heard people when they wanna get rid of unwanted hair. You took a tiny little needle and go down inside the hair follicle and then with electrical current then sort of cauterize just the hair follicle and kill the follicle and that works very well, so we just see the abnormal lashes and typically do this with a microscope so I go in and I go down the hair follicle of the eye lash and then we just with this tiny wire connected to a cautery- type system and then we gently cauterize that hair follicle and we do each individual eyelash and that works very well. And so this person that came in that’s what we did. We actually went in and did epilation with a cautery and that typically works very well.
So if you have any questions about Trichiasis or any other questions you can always contact us through the website. I’ll be happy to try to answer questions that you have and as you not have any problems, great! May God bless you with healthy eyes and great vision.