eMedicine Specialties > Ophthalmology > Lid

Distichiasis: Follow-up

Author: Soheila Rostami, MD, Consulting Staff, Ophthalmic Plastic Consultants
Contributor Information and Disclosures

Updated: Jul 8, 2008

Follow-up

Complications

  • In some cases, differentiation of acquired distichiasis from trichiasis may be difficult. In trichiasis, the lashes grow from the anterior lamella, not from the meibomian orifices (see Media file 1). After lid reconstruction, this distinction may not be possible, especially if a skin graft was used.
  • Entropion may be confused with distichiasis. The lids must be held in their proper position to evaluate the lashes. Careful examination of the lid anatomy and the lid position prevents the misdiagnosis.
  • Epiblepharon is a condition that is mostly present in children. In this condition, the lashes are not truly misdirected, but pushed by the fold of pretarsal skin against the globe.
  • Lid scar, chronic blepharoconjunctivitis, and cicatricial conjunctivitis are other conditions that can be confused with distichiasis.
  • Complications of surgical interventions are hemorrhage, infection, wound dehiscence, lid margin deformities, entropion or ectropion, and regrowth.

Miscellaneous

Medicolegal Pitfalls

  • Constant rubbing of lashes against the cornea, especially in the acquired type of distichiasis, can cause corneal epithelial defect, corneal ulcers, or corneal scars. Treatment of distichiasis in a timely fashion is extremely important.
  • Prior to surgical treatment of distichiasis, patients need to be informed of the complications, especially the recurrence rate and lid deformities. Patients should understand all of the complications and even the treatment of them, if any are present.
 


More on Distichiasis

Overview: Distichiasis
Differential Diagnoses & Workup: Distichiasis
Treatment & Medication: Distichiasis
Follow-up: Distichiasis
Multimedia: Distichiasis
References
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References

  1. 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].

  2. 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.

  3. 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].

  4. Anderson RL. Surgical repair for distichiasis. Arch Ophthalmol. Jan 1977;95(1):169. [Medline].

  5. Bosniak S. Principles and Practice of Ophthalmic Plastic and Reconstructive Surgery. Vol 1. WB Saunders Co; 1996:409.

  6. Dortzbach RK. Ophthalmic Plastic Surgery: Prevention and Management of Complications. Lippincott-Raven Publishers; 1994:42-8.

  7. Fein W. Surgical repair for distichiasis, trichiasis, and entropion. Arch Ophthalmol. May 1976;94(5):809-10. [Medline].

  8. Hill JC. Trichiasis and distichiasis. Can J Ophthalmol. Oct 1976;11(4):353-4. [Medline].

  9. 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].

  10. Scheie HG, Albert DM. Distichiasis and trichiasis: origin and management. Am J Ophthalmol. Apr 1966;61(4):718-20. [Medline].

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Further Reading

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Keywords

abnormal eyelash growth, extra eyelashes, meibomian glands

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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.

Medical Editor

Jorge G Camara, MD, Professor of Ophthalmology, Department of Surgery, University of Hawaii John A Burns School of Medicine; Chairman, Department of Ophthalmology and Otorhinolaryngology, Director of Fellowship Training Program, St Francis Medical Center
Jorge G Camara, MD is a member of the following medical societies: American Academy of Ophthalmology and American Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Simon K Law, MD, PharmD, Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles
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.

Managing Editor

Mark T Duffy, MD, PhD, Consulting Staff, Division of Oculoplastic, Orbito-facial, Lacrimal, and Reconstructive Surgery, Green Bay Eye Clinic, 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 Consulting fee Consulting; Quest medical - lacrimal balloons Honoraria Speaking and teaching

CME Editor

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.

 
 
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