Misdirection of the eyelashes is a common source of ocular irritation. 

 Corneal changes range from 

• mild punctate epitheliopathy 
• ulceration,
• 2ry infection
• scarring
• perforation.

 Classification in Eyelash disorders 

 Trichiasis 

 Distichiasis 
• congenital 
• acquired

 pseudotrichiasis 

 Trichiasis in Eyelash disorders 

 Lashes arise from their normal position but are posteriorly directed due to minor scarring of the lid margin or lash orifice.

 Congenital (distichiasis) in Eyelash disorders 

 Lashes arise from an abnormal position (from or slightly posterior to the MGs). 

 an uncommon congenital abnormality 

 may be sporadic or autosomal dominant (AD). 

 Can rarely be associated with Meige’s (lymphoedema-distichiasis) syndrome.

 Acquired distichiasis in Eyelash disorders 

 Lashes arise from an abnormal position 2ry to chronic injury

• meibomitis
• cicatrizing conjunctivitis 
• surgical trauma.

 Pseudotrichiasis in Eyelash disorders 

 Lashes arise from the normal position but are posteriorly directed due to marginal entropion.

 Treatment options for Eyelash disorders 

 Preventative

• Prevention is better than cure 

• management of MGD disease

• immunosuppression of cicatricial conjunctival diseases

• meticulous surgical eyelid margin reapposition to prevent notches.

 Lash removal
• Epilation.

 Lash destruction

• Electrolysis
• cryotherapy (double freeze-thaw technique 25s freeze, 4min thaw, with or without grey line split)
• lash root trephination
• photoablation, argon or diode laser are all useful techniques for small numbers of lashes. 
• these techniques need to be used with caution and attention to the underlying condition, as they can cause inflammation, scarring, and loss of tarsal plate that can exacerbate the condition.

 Surgery

• marginal entropion, surgical correction is required, with technique depending on degree of entropion and underlying cause

• Jones retractor plication ± horizontal lid tightening.

• Anterior lamellar repositioning ± grey line split ± mucous membrane or hard palate graft.

• Anterior lamellar excision of lash roots.
• tarsal fracture with 180° rotation ± mucous membrane graft.

Eyelash disorders powerpoint presentations 

Eyelash Disorders

TRICHIASIS • It refers to inward misdirection of cilia with normal position of the lid margin. • Common causes of trichiasis are :cicatrising trachoma,ulcerative blepaharitis,healed membranous conjunctivitis,hordeolum externum,mechanical injuries,burns,operative scar on the lid margin.

 Clinical features • Symptoms :-These include foreign body sensation and photophobia.patient may feel troublesome irritation ,pain and lacrimation. • Signs:- • >misdirected cilia one or more touching the cornea. • >conjunctiva may be congested • >reflex blepharospasm and photophobia occur

Disorders of lashes

DISORDERS OF LASHES 1. Trichiasis 2. Metaplastic lashes 3. Distichiasis 4. Phthiriasis palpebrarum 5. Madarosis 6. Poliosis

Eyelash disorders Videos:

Trichiasis of the upper eye lid argon laser ablation video