What does inverted eyelashes mean? Take it seriously

Eyelash inversion is a very annoying disease. In mild cases, it may only affect vision, but in severe cases it can cause major diseases such as corneal inflammation. Moreover, this disease is not limited by age and anyone from young children to the elderly can be affected.

Trichiasis refers to an abnormal eyelash position in which the eyelashes fall toward the eyeball, irritating the cornea and conjunctiva. It often exists together with entropion, but there may also be only inverted eyelids without entropion. The cause of inverted eyelashes is often due to entropion of the eyelids, blepharitis, especially ulcerative blepharitis, which causes scar contraction of the hair follicles. In addition, eyelid folds are common causes of inverted eyelashes.

Clinical symptoms: 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.

Treatment plan: If the eyelashes severely irritate the cornea and the child tears a lot at the age of 5 to 6, surgery can be considered. Younger children can undergo suture correction, which uses the pulling force of sutures to pull the eyelid margin outward. This method is simple, requires a short general anesthesia time, and is safe, but it is prone to recurrence, with some patients experiencing recurrence months or even years later. If the patient is older and has severe entropion, partial resection of the lower eyelid skin and orbicularis oculi muscle can be performed. This surgical method has a high success rate and long-lasting results, but it requires an incision for the lower eyelid blepharoplasty or an incision for the upper eyelid blepharoplasty. The general anesthesia time for the surgery is slightly longer. Some patients will have scars on the lower eyelid after the surgery, and some patients will have the appearance of double eyelids on the lower eyelid. Most parents of children with the disease are afraid of "surgery" and are more likely to accept suture surgery as a "stopgap measure" to alleviate the irritation of trichiasis.

(2) For adults with a small number of localized trichiasis without entropion, the commonly used treatment methods are as follows:

① Removal method: When the number of inverted eyelashes is small, you can directly use eyelash tweezers to remove them. It is simple and effective, but because the eyelash follicles are not destroyed, it is easy to relapse within a few weeks. The eyelashes that grow back will be thicker and harder, which will irritate the cornea. Therefore, plucking them is only done when conditions are poor and there is no other way, or when other methods have been tried and failed.

② Electrolysis: Electrolysis destroys hair follicles and removes them. Sometimes it takes repeated treatments to achieve the desired effect. The success rate is about 10-20%.

③ Cryotherapy: It can relieve many cases of inverted eyelashes. Potential complications include: skin depigmentation, postoperative eyelid notch, damage to the meibomian glands and impact on tear film stability.

④ Laser treatment: Laser separation is effective for a small number of scattered trichiasis.