Double Eyelashes (Distichiasis): Causes & Treatment

Distichiasis is a rare disorder where an abnormal growth of lashes from the orifices of the meibomian glands on the posterior lamella of the tarsal plate occurs.

There are two types of distichiasis; acquired and congenital. Lower lids are mostly involved in acquired form and the lashes can be fully formed, pigmented or non-pigmented, properly oriented or misdirected. The congenital form is dominantly inherited with complete penetrance and canbe associated with ptosis, strabismus, congenital heart defect, or mandibulofacial dysostosis. Distichiasis may be familial in origin with an autosomal dominant inheritance, but may also be produced by acquired conditions such as severe inflammation or trauma.

How does Distichiasis affect your body?

Distichiasis can affect the lower and upper lids. When these abnormal lashes come in contact with the cornea, they may cause severe irritation, epiphora, corneal abrasion and even corneal ulcers.

What are the causes of Distichiasis?

  • Congenital distichiasis is an autosomal dominant condition that is characterized by two parallel rows of cilia at the eyelid margin and lymphedema of the extremities.
  • Acquired distichiasis is more common than the congenital form and is seen more often with chronic inflammatory conditions such as blepharitis, meibomian gland dysfunction (MGD), chemical injuries to the eyes, Stevens-Johnson syndrome.

What are the risk factors of Distichiasis?

There’s no clear knowledge regarding the risk factors of this disorder.

What are the symptoms of Distichiasis?

  • Decrease of vision
  • Pain in eyes
  • Redness
  • Irritation
  • Foreign body sensation
  • Watering
  • Chemosis
  • Corneal scarring
  • Corneal ulcer

How is Distichiasis diagnosed?

Congenital distichiasis is diagnosed by examination which shows eyelashes exiting posterior to the normal row of lashes. The lashes tend to be thinner and shorter than the normal lashes.

Acquired distichiasis is diagnosed by looking for variable number of lashes growing from meibomian gland openings. The aberrant lashes tend to be non-pigmented and stunted, and are usually symptomatic.

How to prevent & control Distichiasis?

There’s no way to prevent distichiasis. However acquired distichiasis may be delayed by proper treatment of diseases such as ocular cicatricial pemphigoid.

Treatment of Distichiasis- Allopathic Treatment

  • Lubricants and bandage contact lenses may be used temporarily to relieve symptoms.
  • Definitive treatment is removal of the abnormal eyelashesbut the eyelashes regrow within 4-6 weeks.
  • Lubricating eye drops and ointment may bring symptomatic relief in patients with epithelial breakdown of the cornea.
  • Soft contact lenses may be used to protect cornea in cases of corneal epithelial breakdown.

Surgical therapy includes:

  • Epilation with electrolysis-This procedure is useful in treating small numbers of isolated or focal areas of distichiasis.
  • Cryosurgery– This procedure may be done to treat wider areas of distichiasis. Cryoprobe freezes the lash follicles and destroys it.
  • Laser thermoablation– This procedure may be used to destroy eyelash follicles.
  • Radiofrequency ablation– In this proceduresmallest gauge wire is introduced alongside the lash to the follicle for destruction with radiofrequency.
  • Lid splitting procedure– This procedure involves an incision in eyelid margin immediately anterior to the distichiatic cilia. The lash follicle is treated with application of electrolysis, excision, or cryotherapy and then the lid incision is closed.

Treatment of Distichiasis- Homeopathic Treatment

No homeopathic treatment is known for distichiasis.

Distichiasis- Lifestyle Tips

People with distichiasis need to undergo surgery for removal of lash follicle as recommended by a doctor. Since follicles can grow again, the procedure for removing it might be done frequently.

What are recommended exercise for person with Distichiasis?

No specific exercise is recommended for people with distichiasis.

Distichiasis & pregnancy- Things to know

Not much is known about correlation between distichiasis and pregnancy. Although it is believed that this disorder is hereditary.

Common complications related to Distichiasis

  • Corneal scarring.
  • Thinning of cornea.
  • Corneal ulcer.
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