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Distichiasis

  • Author: Soheila Rostami, MD, FAACC; Chief Editor: Hampton Roy, Sr, MD  more...
 
Updated: Oct 14, 2015
 

Background

Distichiasis is a rare disorder defined as the abnormal growth of lashes from the orifices of the meibomian glands on the posterior lamella of the tarsal plate (see following image).

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

Two types of distichiasis can be identified, acquired and congenital. In the acquired form, most cases involve the lower lids. Lashes can be fully formed or very fine, pigmented or nonpigmented, properly oriented or misdirected. The congenital form is dominantly inherited with complete penetrance. It can be isolated or associated with ptosis, strabismus, congenital heart defect, or mandibulofacial dysostosis. This defect may be related to the epithelial germ cells failure to differentiate completely to meibomian glands, instead they become pilosebaceous units.

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Pathophysiology

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

This picture demonstrates distichiasis of the loweThis picture demonstrates distichiasis of the lower lid. From Principles and Practice of Ophthalmology by Jakobiec.
This picture demonstrates distichiasis of the uppeThis picture demonstrates distichiasis of the upper lid. From Ophthalmic Plastic Surgery: Prevention and Management of Complications by Dortzbach.
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Epidemiology

Frequency

United States

Distichiasis is a rare disorder.

Race

Distichiasis has been seen in all ethnic backgrounds.

Sex

This condition shows no sex discrimination.

Age

Distichiasis has been seen in all ages.

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Contributor Information and Disclosures
Author

Soheila Rostami, MD, FAACC Director, Rostami Ophthalmic Plastic Consultants

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

Disclosure: Serve(d) as a speaker or a member of a speakers bureau for: Eclipse, Galderma, Mertz.

Specialty Editor Board

Simon K Law, MD, PharmD Clinical Professor of Health Sciences, Department 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, Association for Research in Vision and Ophthalmology, American Glaucoma Society

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, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

References
  1. Allen RC. Genetic diseases affecting the eyelids: what should a clinician know?. Curr Opin Ophthalmol. 2013 Sep. 24(5):463-77. [Medline].

  2. Butler MG, Dagenais SL, Garcia-Perez JL, Brouillard P, Vikkula M, Strouse P, et al. Microcephaly, intellectual impairment, bilateral vesicoureteral reflux, distichiasis, and glomuvenous malformations associated with a 16q24.3 contiguous gene deletion and a Glomulin mutation. Am J Med Genet A. 2012 Apr. 158A(4):839-49. [Medline]. [Full Text].

  3. Moosavi AH, Mollan SP, Berry-Brincat A, et al. Simple surgery for severe trichiasis. Ophthal Plast Reconstr Surg. 2007 Jul-Aug. 23(4):296-7. [Medline].

  4. 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.

  5. McCracken MS, Kikkawa DO, Vasani SN. Treatment of trichiasis and distichiasis by eyelash trephination. Ophthal Plast Reconstr Surg. 2006 Sep-Oct. 22(5):349-51. [Medline].

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

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

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

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

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

  11. Pham RT, Biesman BS, Silkiss RZ. Treatment of trichiasis using an 810-nm diode laser: an efficacy study. Ophthal Plast Reconstr Surg. 2006 Nov-Dec. 22(6):445-7. [Medline].

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

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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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