Causes, Signs and symptoms, Complications and treatment of Trichiasis

Causes, Signs and symptoms, Complications and treatment of Trichiasis


Trichiasis:


The term trichiasis means abnormal direction of the eye lashes. The abnormal lashes rub against the corneal surface of the eye bass with resultant irritation, watering and potential damage to the cornea.

Causes of Trichiasis:


All causes of entropion (entropion = lid margins turn inward) produce trichiasis, for example spasm of muscle of riolan, fibrosis of palpebral conjunctiva, lose of tone and elasticity of lid margins, Steven Johnson's syndrome.
Pure trichiasis occurs in following conditions
1. Congenital Trichiasis: It is also called Distichiasis. In this disorder an extra row of cilia is present behind the grey line in the place of ducts of the meibomian glands. Meibomian glands are absent.
2. Acquired Causes:
a) Trachoma, due to fibrosis distorting the follicles.
b) Ulcerative blepharitis: due to fibrosis near the follicles.

Symptoms and signs of Trichiasis:


1. Sandy or foreign body sensation
2. Photo-phobia
3. Lacrimation (watering)

Complications of Trichiasis:
1. Chronic conjunctivitis
2. Conjunctival ulceration
3. Epithelial plaque
4. Corneal epithelial defects
5. Superficial vascularization
6. Epidermoid change in cornea
4. Secondary bacterial infection.

Treatment for Trichiasis:


Pure trichiasis is treated by operation.
1. If the upper lid is involved then it is corrected by "Van-Millengen's operation" which consist of displacing the rubbing lashes by placing a mucus graft in the grey line.
2. If lower lid is involved then it is corrected by "Webster's operation" in

which a mucus graft is placed in an incision in sulcus subtrasalis.
3. Rubbing lashes if more than four are treated by.
a) Thermal coagulation
b) Diathermy
c) Chemical coagulation (NaOH)
d) Electrolysis.