Distichiasis 

  • Author: Soheila Rostami, MD; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: Nov 22, 2011
 

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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Proceed to Clinical Presentation
 
 
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

  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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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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