How to deal with eyelashes piercing your eyes

Eyes enable us to see the world and everything. One can imagine how important eyes are to humans. At the same time, eyelashes are also very important for the eyes. If you have too few eyelashes, wind and sand will easily blow into your eyes, and flying insects will easily invade your eyeballs. Eyelashes generally grow outwards, making the eyes look big and kidney-like. But what should you do if your eyelashes accidentally prick your eyes?

Normal eyelashes grow on the front lip of the eyelid margin. They develop from the surface ectoderm epithelium and are arranged in 2 to 3 rows. They are short, curved and coarse hairs. Eyelashes have the function of shielding light, blocking dust, preventing foreign objects from entering the eyes and beautifying the eyes. Long, black, and upturned eyelashes play an important role in modifying a person's appearance. There are more eyelashes on the upper eyelid, with 100 to 150 roots, and an average length of 8 to 12 mm. The angle of the upper eyelashes when the eyes are open and looking straight ahead is 110° to 130°, and 140° to 160° when the eyes are closed. There are 50 to 80 eyelashes on the lower eyelid, with an average length of about 6 to 8 mm. The angle of the lower eyelashes when the eyes are open and looking straight ahead is 100° to 120°. The roots of eyelashes are deep in the connective tissue and muscles, where there are abnormal sweat glands and sebaceous glands, whose ducts open into the eyelash follicles. There are many small holes arranged in a row on the posterior lip of the eyelid margin. These holes are the openings of the meibomian gland ducts. The meibomian glands themselves are located in the tarsal plate. Abnormal eyelash tilt angle can be caused by changes in the eyelash growth angle or eyelid diseases. [1][2]

There are many causes of inverted eyelashes. In children and adolescents, it is mainly caused by abnormal growth direction of eyelashes, folds of the lower eyelid, sometimes folds of the lower eyelid combined with epicanthus (as shown in Figure 1), and congenital entropion. In middle-aged and elderly people, entropion is mainly caused by inflammation of the eyelid conjunctiva and scar contraction of the eyelid margin, as well as various other reasons. There are two main causes of trichiasis, including trichiasis without entropion and trichiasis with entropion. Entropion can definitely cause inverted eyelashes, but inverted eyelashes are not necessarily accompanied by entropion. Inverted eyelashes can exist alone. Entropion is an abnormal condition in which the eyelid margin rolls inward toward the eyeball.

When checking for trichiasis, ask the patient to look downward to see if the eyelashes are touching the cornea. Patients often experience pain, red eyes, tearing, photophobia, persistent foreign body sensation, and increased eye secretions. Most children are reluctant to raise their heads, are afraid of light, and are unwilling to cooperate with flashlight or slit lamp examinations. Due to long-term friction of eyelashes, conjunctival congestion, punctate or diffuse damage to the corneal epithelium or partial detachment of the corneal epithelium, superficial corneal opacity, corneal neovascularization, corneal pannus, corneal epithelial thickening, corneal epithelial keratinization, corneal ulcers, and corneal leukoplakia can occur, leading to decreased vision and even blindness in severe cases.

Clinical changes:

Inflammation of the conjunctiva: Due to the repeated stimulation of the conjunctiva and cornea by the eyelashes, conjunctivitis is difficult to cure and often recurs, with tearing and secretions often occurring. When conjunctivitis recurs and does not heal for a long time, some patients develop conjunctival scarring, and a few develop local blepharobulbar adhesions.

Changes in the cornea: Trichiasis can cause punctate or diffuse damage to the corneal epithelium, corneal epithelial detachment, superficial corneal opacities, corneal pannus, corneal epithelial keratinization, corneal ulcers, and corneal leukoplakia, which in turn affect vision.

Others: In addition to corneal lesions affecting vision, trichiasis can sometimes cause astigmatism, which can also affect vision. In children, if the astigmatism is obvious, a small number of them may also cause amblyopia.