Misdirected eye lashes cause recurrent foreign body sensation and scratch the ocular surface.

Trichiasis (ingrowing eyelashes)

Trichiasis describes eyelashes that are misdirected towards the eye. The cause could be any chronic inflammatory condition of the eyelid e.g. blepharitis. Symptoms typically include irritable, sore, red and watery eyes with a constant foreign body sensation. Chronic irritation of the eye by ingrowing eyelashes can lead to localised erosions and ulceration of the cornea (the normally clear “window” at the front of the eye), and this carries a risk to eyesight.

Treatment involves epilation (pulling out) of the aberrant lashes, giving temporary relief for several weeks, or treated more permanently by electrical treatment to the roots of the lashes (electrolysis). This is performed under local anaesthesia and takes a few minutes.

It is normal that more than one session (often 2 or 3) is necessary to eradicate the aberrant eyelash completely. For more extensive areas of trichiasis, freezing treatment (cryotherapy) can also be used, but this carries a risk of lid scarring and distortion and is used only in more severe cases.

Eyelash trephination is another method employed by Ms de Bono to treat persistent misdirected lashes especially in cases of scarred eyelids.