Trichiasis


Will there be scars after entropion surgery?
After the surgery for trichiasis, scars may remain in the eyelid area. However, because the skin on the eyelids has a strong healing ability, the scars usually are not conspicuous. Trichiasis is usually caused by a spasm in the orbicularis oculi muscle inside the eyelid, leading to entropion. Eyelashes poking toward the corneal tissue scratch the corneal epithelium with each blink, causing redness, eye pain, foreign body sensation, photophobia, and tearing. If not treated promptly, it can easily lead to keratitis and may form scars within the corneal tissue, reducing corneal transparency and thus affecting the patient’s vision. Treatment typically requires surgery to remove excess loose skin on the eyelids and to eliminate part of the spasmodic orbicularis oculi muscle, returning the eyelid to its normal position and alleviating the symptoms.


Can vision affected by trichiasis be restored?
If trichiasis affects vision, it indicates that the abrasion of the cornea by the eyelashes has reached a certain degree, and active treatment is necessary. The main goal of the treatment is to prevent the future formation of corneal haze, spotted haze, or leukoma, which can severely impact vision. With active treatment, these conditions generally do not develop, so although trichiasis is a minor condition, if not treated actively, it can lead to serious complications. The primary treatments for trichiasis involve the use of eye drops, such as levofloxacin eye drops and sodium hyaluronate eye drops. If the number of misdirected lashes is small, electrolysis of the eyelashes can be performed. If there are many, surgical treatment may be necessary to correct the inward turning of the eyelid. With active treatment, complete recovery is generally possible. (Please use medication under the guidance of a doctor.)


Is it normal to have one or two inverted eyelashes?
Having one or two eyelashes growing inwards is abnormal. Normally, eyelashes should not rub against the conjunctiva and cornea. If this occurs, do not pluck the eyelashes. Electrolysis surgery can be performed on the eyelashes, and after the surgery, the inturned lashes will not grow back, thus they will no longer affect the conjunctiva and cornea. If inflammation of the conjunctiva and cornea occurs, anti-inflammatory eye drops, such as levofloxacin, and sodium hyaluronate eye drops, which protect the corneal epithelium, can be used for effective treatment. Generally, these issues are not serious and do not affect vision. However, if vision is impacted, further examination and treatment should be sought from an ophthalmologist.


How to deal with inverted eyelashes
For trichiasis, it first depends on the nature of the ingrown eyelashes. If there are only a few, such as one or two, it is recommended to pluck them out. For some people, once these are plucked, the new eyelashes may grow back in the correct position, so no further treatment is necessary. If the ingrown eyelashes recur repeatedly as individual lashes, electrolysis of the hair follicle can be performed to destroy the follicle, preventing the eyelashes from growing back. However, because this is a destructive procedure, many hospitals have discontinued it, though some still offer this treatment. If there are many ingrown eyelashes, appearing in rows, the treatment depends on the position of the eyelid. Eyelash correction surgery may be necessary. Depending on the specific situation, excision of the tarsal plate to correct the trichiasis can be considered as well.


Can trichiasis be noticeable?
Trichiasis can be clearly seen with the naked eye; it causes friction on the conjunctiva, either on the sclera or the cornea, leading to damage to the corneal epithelium. This can result in keratitis, corneal neovascularization, and if not treated promptly, it can lead to further pathological changes in the cornea such as thinning, leukoma, and speckled opacities, severely impacting vision. Simple cases of minimal trichiasis can be treated with electrolysis, but more severe cases should be surgically treated. Complete recovery is possible after surgical treatment for trichiasis.


Does removing inverted eyelashes have any impact on the eyes?
After removing the misdirected eyelashes, it generally does not significantly affect the eyes. However, if they regrow after being plucked, they tend to be harder than before. Repeated plucking can cause inflammation of the eyelid and conjunctiva, long-term abrasion of the cornea, and may lead to the formation of new blood vessels in the cornea. Sometimes, it can also lead to corneal vascularization. Therefore, plucking is not advised. If there are only a few eyelashes, electrolysis can be performed; if there are many, surgical correction is possible, and generally, the results of the surgery are quite good. In such cases, it is advisable to use anti-inflammatory eye drops and eye drops that protect the corneal epithelium, such as levofloxacin and sodium hyaluronate eye drops. (Please consult a doctor before using any medication.)


Is praying to gods and worshipping Buddha effective for trichiasis?
Trichiasis generally has two types, one is simple trichiasis, which can be treated through electrolysis. By using an electric needle to destroy the hair follicle, the follicle will no longer produce eyelashes. The other type is caused by entropion of the eyelid, which requires surgical correction of the entropion to be cured. Therefore, the treatment of trichiasis needs to be conducted in a hospital; praying to gods and worshipping is of no effect and serves only as a psychological effect.


Will surgery for inverted eyelashes leave scars?
The types of trichiasis can be divided into two categories. One type is simple trichiasis, where the eyelashes grow inward. Its treatment can be through electrolysis, which involves using an electric needle to destroy the hair follicle before plucking it out, preventing future eyelash growth from that follicle. The other type is caused by entropion of the eyelid, which requires corrective surgery for the inward-turning eyelid, involving an incision in the skin. Therefore, treatment of this type of trichiasis will result in scars on the skin.


Can people with trichiasis wear contact lenses?
Patients with trichiasis often experience inflammation of the conjunctiva and the cornea, therefore, they cannot wear contact lenses. Once trichiasis occurs, it should be actively treated, especially targeting the trichiasis itself. If it is just a few eyelashes that are inverted, electrolysis of the eyelashes can be performed. If there are many eyelashes inverted, then surgical treatment should be considered. Once the condition stabilizes, contact lenses can be worn. However, since trichiasis affects corneal lesions, a corneal bandage lens can be worn to protect the cornea. Active treatment with eye drops and eye ointments is recommended, and hot compresses should be avoided.


Will the inverted eyelashes grow back after being plucked?
Trichiasis, if plucked, can still regrow, and the new eyelashes may be harder than before, posing a more severe irritation to the conjunctiva and cornea of the eye, so plucking is not recommended. If there are few lashes, electrolysis of the eyelashes can be performed; if there are many, surgery can correct the trichiasis. Once trichiasis occurs, local anti-inflammatory eye drops should be used, such as levofloxacin eye drops, gatifloxacin eye drops, and eye ointment. Use tobramycin eye ointment and erythromycin eye ointment; do not apply heat, take rest, eat a light diet, reduce close work, have regular check-ups, and monitor your vision. (Please use medications under the guidance of a physician.)