Download - 01Disorders of Lashes
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DISORDERS OF LASHES
1. Trichiasis
2. Metaplastic lashes
3. Distichiasis
4. Phthiriasis palpebrarum
6. Poliosis
5. Madarosis
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Trichiasis
• Posterior misdirection of normal lashes
• Most frequently affects lower lid
Complications
• Inferior punctate epitheliopathy
• Corneal ulceration and pannus
Signs
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Treatment Options for Trichiasis
1. Epilation - but recurrences within few weeks
2. Electrolysis - but frequently repeated treatments required
3. Cryotherapy - for many lashes
4. Laser ablation - for few scattered lashes
5. Surgery - for localized crop resistant to other methods
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Metaplastic lashes
Cicatrizing conjunctivitis (ocular pemphigoid, Stevens-Johnson, chemical burns)
Aberrant lashes arising from meibomian gland orifices
Signs Causes
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Distichiasis
• Second row of lashes arising from meibomian gland orifices• Congenital • Cryotherapy to posterior lamella
• Division into anterior and posterior lamellae
• Reapposition of lamellae
TreatmentSigns
• Occasionally dominantly inherited
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Phthiriasis palpebrarum• Infestation of lashes by pubic crab louse and its ova (nits)• Typically affects children in poor hygenic conditions
Treatment - removal, destruction and delousing Lice gripping base of lashes Nits and empty shells adhere to base of lashes
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Madarosis
Local causes• Chronic anterior lid margin disease• Infiltrating tumours• Burns, radiotherapy or cryotherapy
Systemic causes• Generalized alopecia• Myxoedema• SLE• Syphilis• Leprosy
Following removal
Decrease in number or complete loss of lashes
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Poliosis Premature localized whitening of hair
Ocular associations
• Chronic anterior blepharitis
• Sympathetic ophthalmitis
• Vogt-Koyanagi-Harada syndrome
• Waardenburg syndrome
Systemic associations