Distichia

Cory B. Mosunic, MS, DVM, DACVO

What is distichia?

Distichiasis is a condition in which abnormal hairs emerge from the openings (ducts) of glands (Meibomian glands) along the eyelid margin. These glands do not normally produce hairs. These hairs can rub on the surface of the eye and may cause irritation or a corneal ulcer/abrasions.

How are distichia diagnosed?

Signs that a patient may be bothered by distichiasis include: redness, squinting, discharge, or rubbing at the eye. Sometimes distichiasis can cause corneal ulcers or erosions where the hairs touch the surface of the eye. Clinical signs of corneal ulcers are similar to those of distichiasis. Often magnification is required to visualize the hairs due to their small size.

How are distichia treated?

The severity of the problem and the need for treatment vary from patient to patient. Some patients may have only a few distichia (abnormal hairs) on a single eyelid, while others may have several distichia present on all four eyelids. Although some patients live their entire lives without being bothered by their distichia, others require medical or surgical treatment to alleviate irritation caused by the hairs rubbing on the cornea.

Topical ointments may be used to help lubricate the eye and protect the corneal surface from the abnormal lashes. If clinical signs persist then permanent surgical removal of the lash follicles is indicated. There are several treatment options available including cryotherapy and other laser and electroepilation techniques available. Simple manual removal of the lashes without treatment of the follicle only results in temporary relief of clinical symptoms and is not a long-term treatment for this condition. Treatment options should be discussed with your board certified ophthalmologist.

What is the prognosis for distichia?

Although surgery eliminates the distichia from growing back in the treated area, new distichia could potentially emerge from other follicles in the eyelids.

Figure 1: Distichia sample