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Trichiasis, Distichiasis, and Eyelash Ptosis

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Oculofacial, Orbital, and Lacrimal Surgery

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Abstract

Trichiasis refers to eyelashes in normal anatomic position that are misdirected posteriorly toward the ocular surface. This malposition is in contrast to distichiasis, in which accessory eyelashes originate from an abnormal position at or near the Meibomian gland orifices. Lash ptosis is the global declination of upper eyelid lashes despite a well-positioned eyelid margin. In this chapter, we review normal eyelash anatomy as well as the various causes and treatment options to address these abnormal lashes.

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References

  1. Paus R, Burgoa I, Platt CI, Griffiths T, Poblet E, Izeta A. Biology of the eyelash hair follicle: an enigma in plain sight. Br J Dermatol. 2016;174(4):741–52.

    Article  CAS  PubMed  Google Scholar 

  2. Elder MJ. Anatomy and physiology of eyelash follicles: relevance to lash ablation procedures. Ophthal Plast Reconstr Surg. 1997;13(1):21–5.

    Article  CAS  PubMed  Google Scholar 

  3. Thibaut S, De Becker E, Caisey L, et al. Human eyelash characterization. Br J Dermatol. 2010;162(2):304–10.

    Article  CAS  PubMed  Google Scholar 

  4. Montagna W, Ford DM. Histology and cytochemistry of human skin. 3. The eyelid. Arch Dermatol. 1969;100(3):328–35.

    Article  CAS  PubMed  Google Scholar 

  5. Kirkwood BJ, Kirkwood RA. Trichiasis: characteristics and management options. Insight. 2011;36(2):5–9.

    PubMed  Google Scholar 

  6. O’Donnell BA, Collin JR. Distichiasis: management with cryotherapy to the posterior lamella. Br J Ophthalmol. 1993;77(5):289–92.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Salour H, Rafati N, Falahi MR, Aletaha M. A comparison of argon laser and radiofrequency in trichiasis treatment. Ophthal Plast Reconstr Surg. 2011;27(5):313–6.

    Article  PubMed  Google Scholar 

  8. Moosavi AH, Mollan SP, Berry-Brincat A, Abbott J, Sutton GA, Murray A. Simple surgery for severe trichiasis. Ophthal Plast Reconstr Surg. 2007;23(4):296–7.

    Article  PubMed  Google Scholar 

  9. Chi MJ, Park MS, Nam DH, Moon HS, Baek SH. Eyelid splitting with follicular extirpation using a monopolar cautery for the treatment of trichiasis and distichiasis. Graefes Arch Clin Exp Ophthalmol. 2007;245(5):637–40.

    Article  PubMed  Google Scholar 

  10. McCracken MS, Kikkawa DO, Vasani SN. Treatment of trichiasis and distichiasis by eyelash trephination. Ophthal Plast Reconstr Surg. 2006;22(5):349–51.

    Article  PubMed  Google Scholar 

  11. Merbs S, Resnikoff S, Bedri Kello A, Mariotti S, Greene G, West SK. Trichiasis surgery for trachoma. Geneva: WHO Publication; 2015.

    Google Scholar 

  12. Dellinger MT, Thome K, Bernas MJ, Erickson RP, Witte MH. Novel FOXC2 missense mutation identified in patient with lymphedema-distichiasis syndrome and review. Lymphology. 2008;41(3):98–102.

    CAS  PubMed  Google Scholar 

  13. Anderson RL, Harvey JT. Lid splitting and posterior lamella cryosurgery for congenital and acquired distichiasis. Arch Ophthalmol. 1981;99(4):631–4.

    Article  CAS  PubMed  Google Scholar 

  14. Chiou AG, Florakis GJ, Kazim M. Management of conjunctival cicatrizing diseases and severe ocular surface dysfunction. Surv Ophthalmol. 1998;43(1):19–46.

    Article  CAS  PubMed  Google Scholar 

  15. Bearden W, Anderson R. Trichiasis associated with prostaglandin analog use. Ophthal Plast Reconstr Surg. 2004;20(4):320–2.

    Article  PubMed  Google Scholar 

  16. Mabey DC, Solomon AW, Foster A. Trachoma. Lancet (London, UK). 2003;362(9379):223–9.

    Article  Google Scholar 

  17. Wood JR, Anderson RL. Complications of cryosurgery. Arch Ophthalmol. 1981;99(3):460–3.

    Article  CAS  PubMed  Google Scholar 

  18. Al-Bdour MD, Al-Till MI. Argon laser: a modality of treatment for trichiasis. Int J Biomed Sci. 2007;3(1):56–9.

    PubMed  PubMed Central  Google Scholar 

  19. Vaughn GL, Dortzbach RK, Sires BS, Lemke BN. Eyelid splitting with excision or microhyfrecation for distichiasis. Arch Ophthalmol. 1997;115(2):282–4.

    Article  CAS  PubMed  Google Scholar 

  20. Reacher MH, Munoz B, Alghassany A, Daar AS, Elbualy M, Taylor HR. A controlled trial of surgery for trachomatous trichiasis of the upper lid. Arch Ophthalmol. 1992;110(5):667–74.

    Article  CAS  PubMed  Google Scholar 

  21. Bleyen I, Dolman PJ. The Wies procedure for management of trichiasis or cicatricial entropion of either upper or lower eyelids. Br J Ophthalmol. 2009;93(12):1612–5.

    Article  CAS  PubMed  Google Scholar 

  22. Kim GN, Yoo WS, Kim SJ, et al. The effect of 0.02% mitomycin C injection into the hair follicle with radiofrequency ablation in trichiasis patients. Korean J Ophthalmol. 2014;28(1):12–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Ferreira IS, Bernardes TF, Bonfioli AA. Trichiasis. Semin Ophthalmol. 2010;25(3):66–71.

    Article  PubMed  Google Scholar 

  24. Sakarya Y, Sakarya R, Yildirim A. Electrolysis treatment of trichiasis by using ultra-fine needle. Eur J Ophthalmol. 2010;20(4):664–8.

    Article  PubMed  Google Scholar 

  25. Bartley GB, Bullock JD, Olsen TG, Lutz PD. An experimental study to compare methods of eyelash ablation. Ophthalmology. 1987;94(10):1286–9.

    Article  CAS  PubMed  Google Scholar 

  26. Kezirian GM. Treatment of localized trichiasis with radiosurgery. Ophthal Plast Reconstr Surg. 1993;9(4):260–6.

    Article  CAS  PubMed  Google Scholar 

  27. Yung CW, Massicotte SJ, Kuwabara T. Argon laser treatment of trichiasis: a clinical and histopathologic evaluation. Ophthal Plast Reconstr Surg. 1994;10(2):130–6.

    Article  CAS  PubMed  Google Scholar 

  28. Gossman MD, Yung R, Berlin AJ, Brightwell JR. Prospective evaluation of the argon laser in the treatment of trichiasis. Ophthalmic Surg. 1992;23(3):183–7.

    CAS  PubMed  Google Scholar 

  29. Huneke JW. Argon laser treatment for trichiasis. Ophthal Plast Reconstr Surg. 1992;8(1):50–5.

    Article  CAS  PubMed  Google Scholar 

  30. Awan KJ. Argon laser treatment of trichiasis. Ophthalmic Surg. 1986;17(10):658–60.

    CAS  PubMed  Google Scholar 

  31. Basar E, Ozdemir H, Ozkan S, Cicik E, Mirzatas C. Treatment of trichiasis with argon laser. Eur J Ophthalmol. 2000;10(4):273–5.

    Article  CAS  PubMed  Google Scholar 

  32. Moore J, De Silva SR, O’Hare K, Humphry RC. Ruby laser for the treatment of trichiasis. Lasers Med Sci. 2009;24(2):137–9.

    Article  PubMed  Google Scholar 

  33. Wanner M. Laser hair removal. Dermatol Ther. 2005;18(3):209–16.

    Article  PubMed  Google Scholar 

  34. Pham RT, Biesman BS, Silkiss RZ. Treatment of trichiasis using an 810-nm diode laser: an efficacy study. Ophthal Plast Reconstr Surg. 2006;22(6):445–7.

    Article  PubMed  Google Scholar 

  35. Zabriskie NA, Nordlund JJ, Nerad JA. Unusual skin depigmentation following eyelid cryosurgery. Ophthal Plast Reconstr Surg. 1996;12(4):296–8.

    Article  CAS  PubMed  Google Scholar 

  36. Sullivan JH. The use of cryotherapy for trichiasis. Trans Sect Ophthalmol Am Acad Ophthalmol Otolaryngol. 1977;83(4 Pt 1):708–12.

    CAS  PubMed  Google Scholar 

  37. Johnson RL, Collin JR. Treatment of trichiasis with a lid cryoprobe. Br J Ophthalmol. 1985;69(4):267–70.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Rosner M, Bourla N, Rosen N. Eyelid splitting and extirpation of hair follicles using a radiosurgical technique for treatment of trichiasis. Ophthalmic Surg Lasers Imaging. 2004;35(2):116–22.

    Article  PubMed  Google Scholar 

  39. Wojno TH. Lid splitting with lash resection for cicatricial entropion and trichiasis. Ophthal Plast Reconstr Surg. 1992;8(4):287–9.

    Article  CAS  PubMed  Google Scholar 

  40. Wies FA. Surgical treatment of entropion. J Int Surg. 1954;21:758–60.

    CAS  Google Scholar 

  41. Malik KJ, Lee MS, Park DJ, Harrison AR. Lash ptosis in congenital and acquired blepharoptosis. Arch Ophthalmol. 2007;125(12):1613–5.

    Article  PubMed  Google Scholar 

  42. Culbertson WW, Ostler HB. The floppy eyelid syndrome. Am J Ophthalmol. 1981;92(4):568–75.

    Article  CAS  PubMed  Google Scholar 

  43. Langford JD, Linberg JV. A new physical finding in floppy eyelid syndrome. Ophthalmology. 1998;105(1):165–9.

    Article  CAS  PubMed  Google Scholar 

  44. Casson RJ, Selva D. Lash ptosis caused by latanoprost. Am J Ophthalmol. 2005;139(5):932–3.

    Article  PubMed  Google Scholar 

  45. Mulhern MG, Aduriz-Lorenzo PM, Rawluk D, Viani L, Eustace P, Logan P. Ocular complications of acoustic neuroma surgery. Br J Ophthalmol. 1999;83(12):1389–92.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Guimaraes FC, Cruz AA. Eyelid changes in long-standing leprosy. Ophthal Plast Reconstr Surg. 1998;14(4):239–43.

    Article  CAS  PubMed  Google Scholar 

  47. Lee TE, Lee JM, Lee H, Park M, Kim KH, Baek S. Lash ptosis and associated factors in Asians. Ann Plast Surg. 2010;65(4):407–10.

    Article  CAS  PubMed  Google Scholar 

  48. Netland PA, Sugrue SP, Albert DM, Shore JW. Histopathologic features of the floppy eyelid syndrome. Involvement of tarsal elastin. Ophthalmology. 1994;101(1):174–81.

    Article  CAS  PubMed  Google Scholar 

  49. Schlotzer-Schrehardt U, Stojkovic M, Hofmann-Rummelt C, Cursiefen C, Kruse FE, Holbach LM. The pathogenesis of floppy eyelid syndrome: involvement of matrix metalloproteinases in elastic fiber degradation. Ophthalmology. 2005;112(4):694–704.

    Article  PubMed  Google Scholar 

  50. Dutton JJ. Surgical management of floppy eyelid syndrome. Am J Ophthalmol. 1985;99(5):557–60.

    Article  CAS  PubMed  Google Scholar 

  51. Mills DM, Meyer DR, Harrison AR. Floppy eyelid syndrome: quantifying the effect of horizontal tightening on upper eyelid position. Ophthalmology. 2007;114(10):1932–6.

    Article  PubMed  Google Scholar 

  52. Pang HG. Surgical formation of upper lid fold. Arch Ophthalmol. 1961;65:783–4.

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Ophthalmology, Albany Medical College, Albany, NY, USA

    Valerie H. Chen & Edward J. Wladis

  2. Ophthalmic Plastic Surgery, Lions Eye Institute, Slingerlands, NY, USA

    Valerie H. Chen & Edward J. Wladis

  3. Ophthalmic Plastic Surgery, Lions Eye Institute-Albany Medical Center, Slingerlands, NY, USA

    Dale R. Meyer

Authors
  1. Valerie H. Chen
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  2. Dale R. Meyer
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  3. Edward J. Wladis
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Corresponding author

Correspondence to Valerie H. Chen .

Editor information

Editors and Affiliations

  1. Eyelid and Facial Plastic and Reconstructive Surgery and MediSpa, Diseases and Surgery of the Orbit & Lacrimal System Neuro-ophthalmology, Glenview/Chicago, IL, USA

    Adam J. Cohen

  2. Oculoplastics, Orbital, and Cosmetic Facial Surgery, University of Wisconsin, Madison Department of Ophthalmology and Visual Sciences, Madison, WI, USA

    Cat Nguyen Burkat

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Chen, V.H., Meyer, D.R., Wladis, E.J. (2019). Trichiasis, Distichiasis, and Eyelash Ptosis. In: Cohen, A., Burkat, C. (eds) Oculofacial, Orbital, and Lacrimal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-14092-2_10

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  • DOI: https://doi.org/10.1007/978-3-030-14092-2_10

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-14090-8

  • Online ISBN: 978-3-030-14092-2

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