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We have read with keen interest the article on trachomatous
trichiasis by Bowman et al. We fully endorse the authors' observations that
Trachoma and its sequelae are on the decline even in developing countries
as we are witnessing similar trends in south-east Asia,particlarly India.
However,we would like to raise a few pertinent issues.
It is our considered opinion that self-epilation of tri...
It is our considered opinion that self-epilation of trichiatic
eyelashes should not be encouraged as it requires a considerable degree of
patient education and training.In patients with compromised vision due to
corneal opacities,prebyopes and those with poor training skills,it can
prove to be a fairly risky proposition as the patient may inadvertantly
damage vital stuctures such as the cornea and eyelid margin.
Secondly, even in cases which the authors have classified as minor
forms of trichiasis,repeated epilation may not be a preferable option as
the eyelashes which regrow after epilation are usually short with
extremely sharp tips and carry a greater potential for corneal damage than
the longer,unepilated eyelashes.Repeated epilation could lead to
alteration in morphology of the sharp posterior lid margin,which is so
crucial for tear film dynamics and lacrimal pump function.
Therefore,in our experience,we feel that patients with
trichiasis,whether major or minor,should be subjected to a definitive
procedure after the active trachomatous process has been controlled.This
would entail surgical intervention if associated with a marked degree of
entopion,or electrolysis if the trichiatic component alone is predominant.