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disorders of lashes
This document summarizes several disorders of the eyelashes including trichiasis, metaplastic lashes, distichiasis, phthiriasis palpebrarum, madarosis, and poliosis. Trichiasis involves the misdirection of normal lashes toward the eye and can cause punctate epitheliopathy and corneal issues. Metaplastic lashes arise from meibomian gland orifices due to conditions like cicatrizing conjunctivitis. Distichiasis has a second row of lashes from the meibomian glands that may be treated by cryotherapy or surgery. Phthiriasis palpebrarum is an infestation by crab lice.
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disorders of lashes
- 1. DISORDERS OF LASHES 1. Trichiasis 2. Metaplastic lashes 3. Distichiasis 4. Phthiriasis palpebrarum 5. Madarosis 6. Poliosis
- 2. Trichiasis Signs Complications • Posterior misdirection of normal lashes • Inferior punctate epitheliopathy • Most frequently affects lower lid • Corneal ulceration and pannus
- 3. Treatment Options forTrichiasis 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
- 4. Metaplastic lashes Signs Causes Aberrant lashes arising from meibomian Cicatrizing conjunctivitis (ocular pemphigoid, gland orifices Stevens-Johnson, chemical burns)
- 5. Distichiasis Signs Treatment • Second row of lashes arising • Division into anterior and posterior from meibomian gland orifices lamellae • Congenital • Cryotherapy to posterior lamella • Occasionally dominantly inherited • Reapposition of lamellae
- 6. Phthiriasis palpebrarum • Infestationof lashes by pubic crab louse and its ova (nits) • Typically affects children in poor hygenic conditions Lice gripping base of lashes Nits and empty shells adhere to base of lashes Treatment - removal, destruction and delousing
- 7. Madarosis Decrease in numberor complete loss of lashes Local causes • Chronic anterior lid margin disease • Infiltrating tumours • Burns, radiotherapy or cryotherapy Systemic causes • Generalized alopecia • Myxoedema • SLE • Syphilis • Leprosy Following removal
- 8. Poliosis Premature localized whiteningof hair Ocular associations • Chronic anterior blepharitis • Sympathetic ophthalmitis Systemic associations • Vogt-Koyanagi-Harada syndrome • Waardenburg syndrome