Electropilation: Trichiasis

What is Trichiasis?

Trichiasis is a common eyelid problem. Eyelashes grow inwards toward the eye. The lashes rub against the cornea, the conjunctiva, and the inner surface of the eyelids. This irritates the eye.

What causes trichiasis?

Sometimes people get trichiasis and there is no known cause. Anyone can develop trichiasis. It is more common in adults. Some causes of trichiasis include:

• eye infection
• inflammation (swelling) of the eyelid
• autoimmune conditions
• trauma

Certain conditions increase your risk of developing trichiasis:

• Epiblepharon. This is a congenital disorder. Loose skin around the eye forms a fold. This causes the lashes to assume a vertical position. This is mostly found in children of Asian ancestry.
• Herpes zoster eye disease.
• Trauma to the eye, such as burns.
• Chronic blepharitis. This is a common and ongoing condition. The eyelids become swollen. Oily particles and bacteria coat the lid margin near the base of the eyelashes.
• Trachoma. This is a severe eye infection found in developing nations.
• Rare disorders of the skin and mucous membranes. (Stevens-Johnson syndrome and cicatricial pemphigoid)

What are the symptoms?

our eye may feel irritated by the sensation of having something in your eye.

Other symptoms include:

• redness
• tearing, and
• sensitivity to bright light

Eyelashes that rub against the cornea for a long time can cause a corneal abrasion or even a corneal ulcer.

What is the treatment?

Trichiasis treatment involves removing the eyelash, follicle or both, or redirecting eyelash growth.

Sometimes trichiasis affects only a few eyelashes. Your ophthalmologist may simply remove them with forceps (tweezers). There is a chance the eyelashes may grow back again in the wrong direction.

If you have many lashes growing toward your eye, surgery can remove them permanently. Ablation surgery uses radio frequencies or lasers to remove the lashes and hair follicles. Your ophthalmologist will numb your eye before the outpatient procedure.

Other surgical treatments include:

• Electrolysis/electropilation: This process uses electricity to permanently remove hair. While effective, electrolysis is time-consuming and can be painful.
• Cryosurgery: This removes the lashes and follicles by freezing them. Cryosurgery is effective but has the potential for complications.

Your ophthalmologist may recommend surgery to reposition the eyelashes. This can be the case if your trichiasis is due to epiblepharon.

What is Electrolysis or Electropilation?

It is a method of hair or eyelash removal. It was first used successfully in 1875 to remove eyelashes.

How does it work?

It works by passing a small amount of energy into the hair follicle through a very fine needle. This produces heat, which destroys the cells that produce the hair at the base of the follicle. More than one treatment session may be necessary because it is not possible to see through the skin to identify the exact position of the hair follicle.

Does Electrolysis Hurt?

The nurse or doctor performing electrolysis will put anaesthetic drops in your eye and then numb the eyelid with a small injection of an anaesthetic. Some discomfort is common as the local anaesthetic is given, but the electrolysis procedure is usually comfortable. You will not be put to sleep for this.

After the electrolysis, we will give you antibiotic ointment to use for the next week. The injection will wear off after 1–2 hours and the eyelid may feel a little sore during this time. It is usually a good idea to take your preferred painkiller during this time.

What are the complications?

• Re-growth of the eyelash. The treatment is only effective if given to the growing root of the eyelash. See “How does it work?”
• Scarring on the edge of the eyelid can occur after repeated sessions of electrolysis.
• You will be asked to keep very still during the procedure because the treatment is very close to the eye. This will reduce the risk of accidental damage.

What are the benefits?

The doctor that examined your eyes in the Eye Clinic has noticed that one or more of your eyelashes are growing inwards towards your eye.

You have probably noticed an uncomfortable, scratchy feeling and if we let this continue, it can cause eye infections and ulcers on the surface of your eye.

Plucking the eyelash with tweezers at home will give you instant relief of the symptoms, but the eyelash will soon grow back in the wrong direction again!

NEXT STEP

Before you agree to the test or the procedure make sure you know:

• The name of the test or procedure
• The reason you are having the test or procedure
• What results to expect and what they mean
• The risks and benefits of the test or procedure
• What the possible side effects or complications are
• When and where you are to have the test or procedure
• Who will do the test or procedure and what that person’s qualifications are
• What would happen if you did not have the test or procedure
• Any alternative tests or procedures to think about
• When and how will you get the results
• Who to call after the test or procedure if you have questions or problems
• How much will you have to pay for the test or procedure