Long and dense eyelashes enhance the beauty of the eyes. However, if they grow in the wrong way ie. instead of growing out they grow in, severe discomfort can occur. If untreated, the chronic rubbing of the eyelashes against cornea may give rise to scarrings and visual loss. This woman had ocular inflammation as a result of adverse reaction to medication (Steven-Johnson's syndrome), the right eye was painful and had poor vision as a result of ingrowing eyelashes of the upper eyelids (Figure 1).
Figure 1. Right red eyes and corneal scarring from
ingrowing eyelashes of the upper eyelid.
There are several ways of treating this condition. The easiest way is to pull out the eyelashes (epilation). However, the eyelashes will eventually grow back and epilation need to be repeated at regular interval. The alternative is with electrolysis, however, the process is laborious in this patients as the whole upper eyelashes were involved. Furthermore, electrolysis is not 100% successful. To achieve a more permanent result, surgery is a better option for this patient. There are several surgical methods described for this condition. The technique chosen here is called tarsal rotation (Figure 2) and has the advantages of faster recovery and without external eyelid incision scars.
Figure 2. Steps showing the tarsal rotation technique.
Three sutures were used to evert the upper eyelashes.
Figure 3. Post-operative picture taken at one-week
shows improved right eye appearance.