Trichiasis is the misdirection of eyelashes toward the globe. Instead of the lashes pointing away from the eye, they turn in towards the eye.
It can be asymptomatic or cause pain, foreign body sensation, red eye, tearing, and corneal scratches leading to infection and scarring.
In children is it often due to the lashes changing with age, and it often is temporary. It can also be due to eye rubbing which can mechanically turn the lashes. Some children have epiblepharon which is a congenital disorder where there is an extra fold of eyelid skin on the lower lid that pushes the lashes into a vertical position. It is often noted shortly after birth and most commonly is seen in children of Asian or Hispanic ancestry.
Often this is a temporary issue in children. Artificial tear ointment will protect the surface of the eye. If there is a scratch on the eye, antibiotic drops may be necessary. The misdirected lashes can be pulled, but they typically grow back short and stiff in 6-8 weeks and can be more irritating. If there are signs of infection, scarring or vision loss, the lash follicles can be destroyed in the operating room. If the cause is epiblepharon, surgery can be done to remove the excess skin and rotate the eyelid.
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