the Impact of Lower Eyelashes Sticking to the Eye in Toddlers

The lower eyelashes are stuck to the eyeball?

A child who is one year and nine months old has had the lower eyelashes of both the left and right eyes sticking to the eyeballs since birth.
What impact could this have, and is any treatment necessary?

Ya Ya Ma, 30~39 year old female. Ask Date: 2015/10/19

Dr. Xiao Kaiwen reply Pediatrics

The most common cause of entropion is eyelid dermatochalasis, which occurs when the muscles and skin of the eyelid become thickened, pushing the eyelashes toward the eyeball.
This condition is more frequently seen in Asian infants, primarily affecting the lower eyelid, and is often bilateral.
In most cases, it resolves naturally within a few years after birth.
According to statistics, 80% of eyelid dermatochalasis does not have any significant impact.
However, if the resulting entropion causes damage to the cornea, special treatment is required, and it is recommended to seek evaluation from an ophthalmologist.

Reply Date: 2015/10/19

More Info

The condition you are describing, where a toddler's lower eyelashes are sticking to the eyeball, is known as "trichiasis." This condition can occur when the eyelashes grow inwards towards the eye instead of outward. In young children, this can be particularly concerning as it may lead to various complications, including irritation, discomfort, and potential damage to the cornea or conjunctiva.

Potential Impacts
1. Irritation and Discomfort: The constant contact of the eyelashes with the eye can cause irritation, leading to symptoms such as redness, tearing, and discomfort. Children may rub their eyes more frequently, which can exacerbate the irritation.

2. Corneal Damage: If the eyelashes continuously rub against the cornea, it can lead to corneal abrasions or ulcers. This is particularly concerning as the cornea is a sensitive part of the eye, and any damage can affect vision.

3. Infection Risk: The irritation and potential damage to the eye can increase the risk of infections, such as conjunctivitis (pink eye). An infected eye can lead to further complications if not treated promptly.

4. Vision Problems: In severe cases, if the condition is not addressed, it could potentially lead to vision problems. This is particularly important in young children, as their visual development is critical during the early years.

Need for Treatment
Given the potential complications associated with this condition, it is advisable to seek an evaluation from a pediatric ophthalmologist. They can assess the severity of the situation and determine the best course of action. Treatment options may include:
- Observation: In some cases, if the eyelashes are not causing significant irritation or damage, the doctor may recommend simply monitoring the situation.

- Epilation: This is a procedure where the problematic eyelashes are removed. This can provide immediate relief from irritation.

- Surgical Intervention: If the condition is severe or persistent, surgical options may be considered to reposition the eyelashes or correct the eyelid's anatomy.

- Lubricating Eye Drops: To alleviate discomfort, lubricating eye drops may be recommended to keep the eye moist and reduce irritation.

Conclusion
In summary, while the condition of lower eyelashes sticking to the eye in toddlers can lead to several complications, the extent of the impact largely depends on the severity of the situation. It is essential to consult with a pediatric ophthalmologist to evaluate the condition and determine the appropriate treatment. Early intervention can help prevent potential complications and ensure the child's eye health and comfort. Regular eye examinations are crucial, especially in young children, to monitor their visual development and address any issues promptly.

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