Eyelid
Misdirected or extra eyelashes that rub against the eye — causing irritation, tearing, and corneal damage — and the procedures that permanently redirect or remove them.
Medically reviewed by Karen L. Chapman, MD, FACSOculoplastic SurgeonLast updated June 2026
Your Surgeon
Karen L. Chapman, MD, FACS
Karen L Chapman MD - Oculoplastics
🏅 ASOPRS Fellow
Normal eyelashes curve away from the eye. When lashes grow toward the eye and rub the cornea and conjunctiva, every blink abrades the ocular surface — causing foreign-body sensation, redness, tearing, light sensitivity, and over time real corneal damage: erosions, scarring, thinning, and vascularization.
Trichiasis is acquired misdirection of otherwise normal lashes, with the eyelid margin itself in normal position. Common causes include chronic blepharitis and meibomian gland disease, prior eyelid trauma or surgery, ocular cicatricial conditions (e.g. Stevens–Johnson syndrome, ocular cicatricial pemphigoid), and infection (trachoma is the leading cause worldwide). It must be distinguished from entropion, where the whole lid margin rolls inward — that requires eyelid surgery rather than lash-directed treatment.
Distichiasis is a second, extra row of lashes emerging from the meibomian (oil) gland openings behind the normal lash line. It may be congenital (sometimes familial, associated with lymphedema-distichiasis syndrome) or acquired after chronic inflammation. Because these fine extra lashes sit on the back edge of the lid margin, they contact the cornea directly.
The right choice depends on how many lashes are involved, whether the cause is cicatricial, and whether the lid margin position is normal — exactly what an oculoplastic evaluation determines.
Your Surgeon
Karen L. Chapman, MD, FACS
Karen L Chapman MD - Oculoplastics
🏅 ASOPRS Fellowship Trained
Schedule a consultation with Karen L. Chapman, MD, FACS to learn if this procedure is right for you.
