Trichiasis Surgery in London

Treating lashes that grow inward

Trichiasis, a condition where eyelashes grow inward toward the eye, causes discomfort and can lead to serious eye complications if untreated.

Trichiasis Definition: A condition where eyelashes grow inward, potentially causing irritation and vision issues.
Common Causes: Includes entropion, epiblepharon, and distichiasis.
Symptoms: Redness, discomfort, and eye irritation.
Treatment Options: Surgery, electrolysis, and anti-inflammatory medications.

What is Trichiasis?

Trichiasis occurs when eyelashes grow abnormally inward toward the eye. Unlike typical lash growth, this condition can irritate the cornea and conjunctiva, potentially leading to more severe complications such as infections or scarring.

How Trichiasis Differs from Other Eyelash Disorders

Entropion: The eyelid itself turns inward, causing lashes to rub against the eye.
Epiblepharon: A fold of skin and muscle pushes lashes inward.
Distichiasis: An extra row of lashes grows abnormally close to the eye.

Trichiasis, on the other hand, involves misdirected lash growth without these underlying eyelid abnormalities.

Trichiasis is a condition where eyelashes become misdirected and grow inwards towards the eye, without any of the above conditions present. Trichiasis can cause the following symptoms:

Trichiasis is caused by:

Infection – A long-term (chronic) infection such as herpes zoster eye disease can cause trichiasis. It is known that trachoma, a disease that is more widespread in developing countries, causes trichiasis.
Eyelid inflammation – Trichophytosis can develop in chronic blepharitis and is a common condition that leads to inflammation of the eyelid margin. Eyelashes become incorrectly oriented as a result of long-term inflammation.
Autoimmune conditions – Rare disorders affecting the skin and mucous membranes such as Stephen-Johnson syndrome and cicatricial pemphigus can lead to trichiasis with the transformation of eyelashes.
Injury – Burns on the eyelid in particular can lead to trichiasis and the wrong orientation of the eyelashes.

Treatment Options for Trichiasis

Non-Surgical Treatments

Epilation: Temporarily removes misdirected lashes.
Electrolysis: Permanently destroys problematic lash follicles.
Lubricating Eye Drops: Reduces irritation and provides temporary relief.

Surgical Solutions

For severe cases, surgical options include:

Cryotherapy: Freezes and destroys lash follicles.
Lid Surgery: Corrects eyelid alignment issues.
Laser Ablation: Targets lash follicles with precision.

Preventing Recurrence

Regular follow-ups with an ophthalmologist
Prompt treatment of underlying conditions like blepharitis
Maintaining proper eyelid hygiene

What you can expect during the procedure?

Depending on the number of growing eyelashes that cause trichophytosis and their location along the eyelid, the following procedures can be performed:

Electrolysis

This is where a precision probe using radio frequencies is inserted into the root of the eyelashes to excise it and destroy the eyelash follicles. This prevents further growth of eyelashes from the root of the eyelashes.

Cryosurgery

Freezing eyelashes and follicles damages them and prevents further regrowth of eyelashes.

Lash root excision

An incision is made along the eyelid margin and the roots of the eyelashes are removed along the trichiasis zone.

Wedge excision

If the trichophytosis is in a localized area of the eyelid and there is a drooping of the eyelid which is common with the aging process, the part of the eyelid containing the trichophytosis area is removed and the remaining healthy eyelid is sutured together again.

Why is trichiasis surgery done?

For severe cases, surgical options include:

Cryotherapy: Freezes and destroys lash follicles.
Lid Surgery: Corrects eyelid alignment issues.
Laser Ablation: Targets lash follicles with precision.
Other Surgical Procedures:
- Ingrowing eyelashes can be plucked or epilated, providing temporary relief from the discomfort they cause.
- Ocular lubricants can also be used to provide some comfort, but the most effective solution is usually surgery.
- Surgery involves removing the ingrowing lashes and/or correcting any underlying conditions that are causing them to grow inwards. Depending on the severity of the condition, surgical procedures may involve removing excess skin and fat, levator stretching, or other treatments. Recovery time can vary depending on the procedure, but it typically takes several weeks before the eyes are fully healed.

What are the risks?

Risks of trichiasis surgery include:

To find out the most applicable risks you should talk to your doctor to understand more about trichomoniasis surgery as well as the benefits and whether it applies to you. This way you can decide with your doctor whether trichiasis surgery is a good option.

How you prepare for trichiasis surgery?

Before having trichiasis surgery, you will meet with an eye plastic surgeon like Mr. Ahmed Aziz at his London Clinic who specializes in trichiasis surgery to discuss:

Your medical history including any previous surgery and current eye conditions.
Your expectations with an honest discussion about what can be realistically achieved.
A vision examination to check the eyes prior to surgery.
A physical examination of the eyelids to ensure that this is the correct procedure.
Eyelid photography which can help with surgical planning and to provide evidence for any insurance claim.

Before undergoing surgery for trichophytosis, it is important to stop taking any blood-thinning drugs such as aspirin, ibuprofen, warfarin, apixaban, and any other drugs that can cause increased bleeding. Your doctor will provide instructions on how long to stop taking these medications before surgery. In addition, it is useful to stop smoking several weeks before surgery to improve the healing process. After the operation, you should arrange for someone to take you home and stay with you for the first night after the operation.

What you can expect before the procedure?

Trichiasis surgery is usually performed as an outpatient procedure, meaning the patient can go home the same day. Before the surgery begins, the surgeon will inject a local anesthetic into the eyelids to numb the area, and may also administer medication through an intravenous drip to help the patient relax. Once the anesthesia has taken effect, the surgeon will proceed with the surgery.

What you can expect after the procedure?

After the surgery is complete, the patient is monitored for any potential complications. Once the patient has been cleared to leave, they can go home to begin the healing process. It is important to follow the instructions given by the medical team regarding any medications or other care that may be needed for proper recovery.

After surgery you may temporarily experience

Blurred vision from the lubricating ointment applied to your eyes at the time of trichiasis surgery
Watering of the eyes
Sensitivity to light
Double vision
Puffy, numb eyelids from the anaesthetic and trichiasis surgery
Swelling and bruising similar to having black eyes which will settle within a week
Pain or discomfort

Your doctor will likely suggest you take the following steps after surgery:

Use ice packs on your eyes every hour the night you go home after the operation. The following day, use ice packs on your eyes four to five times throughout the day to help reduce the swelling
Gently clean your eyelids and use prescribed medication.
Avoid straining, heavy lifting and swimming for a week after blepharoplasty.
Avoid strenuous activities, such as aerobics and jogging, for a week.
Avoid smoking.
Avoid rubbing your eyes.
Not to use contact lenses for about two weeks after surgery.
Wear darkly tinted sunglasses to protect the skin of your eyelids from sun and wind.
Sleep with your head raised higher than your chest for 3 days after the surgery.
After a few days, return to the surgeon to have stitches removed, if needed.

Seek medical attention immediately if you experience any of the following:

What are the results of surgery?

Many patients report being satisfied with the results of trichiasis surgery, as it can lead to a more natural appearance and improved vision if the vision was affected. The effects of the surgery can typically last a lifetime, though in some cases the trichiasis may recur over time if the underlying condition that caused the trichiasis is ongoing or if the patient has only received one treatment of electrolysis.

The bruising and swelling normally settle within two weeks, resulting in a more natural look and increased confidence in being seen in public. Most patients will find that any remaining swelling has resolved within two months.

Scars from the surgery may take a few months to fully fade, but should be located within the skin crease or under the eyelashes, and should generally be well-covered. To reduce the risk of scarring, it is important to protect the eyelids from excessive sun exposure, just as you should do for the rest of your skin.