Distichiasis Clinical Presentation

Author: Soheila Rostami, MD; Chief Editor: Hampton Roy Sr, MD more...

Updated: Nov 22, 2011

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History
Physical
Causes
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References

History

Family history of distichiasis
Previous history, including Stevens-Johnson syndrome, ocular cicatricial pemphigoid (OCP), trauma, and previous surgery

Abnormal lashes from the meibomian gland orifices are noted on slit lamp examination.
The corneal epithelium should be evaluated at the slit lamp after instillation of fluorescein for any defects or abnormalities.

Causes

The congenital form of distichiasis is autosomal dominant with complete penetrance. The metaplasia of meibomian glands and abnormal growth of lashes from these glands, secondary to severe chemical burn, Stevens-Johnson syndrome, OCP, or chronic blepharoconjunctivitis, can cause acquired distichiasis.

Proceed to Differential Diagnoses

Contributor Information and Disclosures

Author

Soheila Rostami, MD Consulting Staff, Ophthalmic Plastic Consultants

Soheila Rostami, MD is a member of the following medical societies: American Academy of Ophthalmology and American Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Jorge G Camara, MD Professor of Ophthalmology, Department of Surgery and Director of Fellowship Training Program in Ophthalmic Plastic and Reconstructive Surgery for Countries Served by the Aloha Medical Mission, University of Hawaii John A Burns School of Medicine

Jorge G Camara, MD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, and American Society of Ophthalmic Plastic and Reconstructive Surgery

Disclosure: Nothing to disclose.

Simon K Law, MD, PharmD Associate Professor of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

Mark T Duffy, MD, PhD Consulting Staff, Division of Oculoplastic, Orbito-facial, Lacrimal and Reconstructive Surgery, Green Bay Eye Clinic, BayCare Clinic; Medical Director, Advanced Cosmetic Solutions, A BayCare Clinic

Mark T Duffy, MD, PhD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, American Society of Ophthalmic Plastic and Reconstructive Surgery, Sigma Xi, and Society for Neuroscience

Disclosure: Allergan - Botox Cosmetic Honoraria Speaking and teaching

Lance L Brown, OD, MD Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

References

Moosavi AH, Mollan SP, Berry-Brincat A, et al. Simple surgery for severe trichiasis. Ophthal Plast Reconstr Surg. Jul-Aug 2007;23(4):296-7. [Medline].
Pham RT. Treat of trichiasis using 810 nm diode laser: an efficacy study. Paper presented at: Annual Meeting of the American Society of Ophthalmic Plastic and Reconstructive Surgery; New Orleans, La. October 22-23, 2004.
McCracken MS, Kikkawa DO, Vasani SN. Treatment of trichiasis and distichiasis by eyelash trephination. Ophthal Plast Reconstr Surg. Sep-Oct 2006;22(5):349-51. [Medline].
Anderson RL. Surgical repair for distichiasis. Arch Ophthalmol. Jan 1977;95(1):169. [Medline].
Bosniak S. Principles and Practice of Ophthalmic Plastic and Reconstructive Surgery. Vol 1. WB Saunders Co; 1996:409.
Dortzbach RK. Ophthalmic Plastic Surgery: Prevention and Management of Complications. Lippincott-Raven Publishers; 1994:42-8.
Fein W. Surgical repair for distichiasis, trichiasis, and entropion. Arch Ophthalmol. May 1976;94(5):809-10. [Medline].
Hill JC. Trichiasis and distichiasis. Can J Ophthalmol. Oct 1976;11(4):353-4. [Medline].
Pham RT, Biesman BS, Silkiss RZ. Treatment of trichiasis using an 810-nm diode laser: an efficacy study. Ophthal Plast Reconstr Surg. Nov-Dec 2006;22(6):445-7. [Medline].
Scheie HG, Albert DM. Distichiasis and trichiasis: origin and management. Am J Ophthalmol. Apr 1966;61(4):718-20. [Medline].

This picture demonstrates distichiasis of the lower lid. From Principles and Practice of Ophthalmology by Jakobiec.

This picture demonstrates distichiasis of the upper lid. From Ophthalmic Plastic Surgery: Prevention and Management of Complications by Dortzbach.

This picture demonstrates the cryotherapy of the lower lid with distichiasis. From Ophthalmic Plastic Surgery: Prevention and Management of Complications by Dortzbach.

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Distichiasis Clinical Presentation

History

Physical

Causes