• distichiasis
• eyelashes
• lymphoedema
• swollen legs

Distichiasis is the presence of aberrant extra eyelashes, and is familiar to adnexal surgeons as these lashes sometimes cause intense irritation of the cornea. This can require removal of the lashes by epilation (plucking), cryotherapy, electrolysis, lid splitting operations, or laser treatment. The lashes are very fine and originate in the meibomian glands at the rear of the tarsal plate. The condition can vary from a few sparse hairs on one lid, to full sets of lashes on both lids. Although individuals are usually aware of the presence of these hairs, quite often they are not. This is probably because of hypoaesthesia of the cornea, and/or outwardly curling lashes.

Lymphoedema is chronic tissue swelling, most frequently of the lower limbs, resulting from deficient lymphatic drainage in the presence of normal capillary function.¹ Primary lymphoedema is caused by an intrinsic abnormality of the lymph conducting pathways, is genetic in origin, and may be present from birth or can develop later, often at or after puberty. The inheritance of …