Distichiasis: Symptoms, Causes, Diagnosis and Treatment

Written by Medicover Team and Medically Reviewed by Dr Vompolu Kamakshi Bhaskar , Ophthalmologists

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Distichiasis is a rare eyelid condition characterized by the growth of an extra row of eyelashes from the openings of the meibomian glands. These additional lashes may rub against the surface of the eye, causing irritation, redness, excessive tearing, light sensitivity, and corneal damage if left untreated. Distichiasis may be present at birth or develop later in life. Early diagnosis and appropriate treatment are important to protect the eye, relieve symptoms, and preserve vision.

What are the Symptoms and Complications of Distichiasis?

Distichiasis is characterized by the presence of an extra row of eyelashes, which can cause symptoms such as eye irritation, redness, excessive tearing, sensitivity to light, and a feeling of something in the eye. If left untreated, it may lead to complications like corneal damage, infections, and vision problems due to constant friction of the extra lashes against the eye surface.

Common Symptoms

Individuals with distichiasis may experience a range of symptoms, varying in severity depending on the number and orientation of the extra eyelashes. Common symptoms include:

Irritation: The constant rubbing of extra eyelashes against the cornea can cause persistent eye irritation.
Redness and Swelling: Inflammation may occur due to the friction and irritation caused by the distichia.
Tearing: The eye may produce excessive tears as a protective mechanism against irritation.
Sensitivity to Light: Photophobia, or sensitivity to light, is a common symptom associated with ocular surface irritation.

Potential Complications

If left untreated, distichiasis can lead to more severe complications affecting eye health. These include:

Corneal Abrasions: The cornea may become scratched or scuffed, leading to pain and potential scarring.
Infections: Continuous irritation can increase the risk of bacterial infections, such as conjunctivitis or keratitis.
Vision Impairment: Severe cases may lead to vision impairment due to corneal damage or scarring.

What are the Causes of Distichiasis?

Distichiasis can be congenital or acquired, with the congenital form being more common. In congenital distichiasis, the condition is often inherited and may present alongside other genetic disorders, such as lymphedema-distichiasis syndrome. This syndrome is characterized by swelling due to lymphatic system abnormalities, coupled with the presence of distichiasis.

Acquired distichiasis, on the other hand, can occur due to chronic inflammation or scarring of the eyelid. Conditions such as blepharitis or ocular pemphigoid may precipitate this form of the disorder. It is crucial to identify the underlying cause to tailor an appropriate treatment strategy.

When to See a Doctor for Distichiasis?

Individuals with persistent eye irritation, redness, excessive tearing, or eyelashes rubbing against the eye should consult an Ophthalmologist to prevent corneal damage and preserve vision.

You should see a doctor if you experience:

Persistent eye discomfort or irritation
Repeated episodes of red or watery eyes
Blurred vision caused by eyelash irritation

Seek immediate medical attention if you:

Develop severe eye pain or sudden vision loss
Notice signs of a corneal ulcer, such as intense redness and light sensitivity
Experience eye injury with persistent pain or discharge

These symptoms may indicate corneal damage or a serious eye infection requiring urgent ophthalmic care.

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How is Distichiasis Diagnosed?

A thorough eye examination by an ophthalmologist is essential for diagnosing distichiasis. The diagnosis involves a detailed assessment of the eyelid margin and the position of the eyelashes. The use of a slit lamp, a microscope with a bright light used to examine the eye, can aid in the detection of extra lashes and any corneal damage.

In some cases, genetic testing may be recommended, especially if lymphedema-distichiasis syndrome or other genetic conditions are suspected. Early diagnosis is critical in preventing complications and initiating effective treatment.

What are the Treatment Options for Managing Distichiasis?

Treatment options for managing distichiasis include lubricating eye drops, removal of extra eyelashes, and procedures like electrolysis or surgery to prevent irritation and protect the eye.

Non-Surgical Treatments

In mild cases of distichiasis, non-surgical interventions may suffice. These include:

Lubricating Eye Drops: Artificial tears can help alleviate dryness and irritation caused by the extra eyelashes.
Eyelid Hygiene: Regular cleaning of the eyelid margin can reduce inflammation and discomfort.
Epilation: Temporary removal of the offending eyelashes using forceps can provide relief, although regrowth is expected.

Surgical Treatments

For more severe cases, surgical intervention may be necessary to prevent corneal damage and alleviate symptoms. Surgical options include:

Cryotherapy: This procedure involves freezing the hair follicles to avoid the regrowth of the distichia. It is an effective method for long-term management.
Electrolysis: This technique uses electric currents to destroy the hair follicles. It is suitable for treating individual or small clusters of eyelashes.
Lid Surgery: In cases where cryotherapy or electrolysis is not effective, surgical realignment or reconstruction of the eyelid may be considered to correct the position of the meibomian glands and prevent future lash growth.

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