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DISORDERS OF LASHES

DISORDERS OF LASHES. 1. Trichiasis. 2. Metaplastic lashes. 3. Distichiasis. 4. Phthiriasis palpebrarum . 5. Madarosis. 6. Poliosis. Trichiasis. Signs. Complications. Inferior punctate epitheliopathy. Posterior misdirection of normal lashes Most frequently affects lower lid.

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DISORDERS OF LASHES

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  1. DISORDERS OF LASHES 1. Trichiasis 2. Metaplastic lashes 3. Distichiasis 4. Phthiriasis palpebrarum 5. Madarosis 6. Poliosis

  2. Trichiasis Signs Complications • Inferior punctate epitheliopathy • Posterior misdirection of normal lashes • Most frequently affects lower lid • Corneal ulceration and pannus

  3. 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

  4. Metaplastic lashes Signs Causes Aberrant lashes arising from meibomian gland orifices Cicatrizing conjunctivitis (ocular pemphigoid, Stevens-Johnson, chemical burns)

  5. Distichiasis Signs Treatment • Division into anterior and posterior • lamellae • Second row of lashes arising • from meibomian gland orifices • Cryotherapy to posterior lamella • Congenital • Reapposition of lamellae • Occasionally dominantly inherited

  6. Phthiriasis palpebrarum • Infestation of 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 number or 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 whitening of hair Ocular associations • Chronic anterior blepharitis • Sympathetic ophthalmitis Systemic associations • Vogt-Koyanagi-Harada • syndrome • Waardenburg syndrome

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