Do you have double eyelids? Let's talk about Distichiasis!

Have you ever seen someone with strange eyelashes, like they're in a double row? Or do you sometimes feel like something is poking your eye, like you've just grown an extra eyelash? That's what we're going to talk about today. This is called Distichiasis in medical terms. Although the name may sound a bit strange, let's explain it simply.

What is Distichiasis? Let's understand it simply!

Simply put, Distichiasis is when you have an extra row of eyelashes on your eyelid. Think about it, normally we have one row of eyelashes. But in this case, an extra row develops. This extra row can be a complete row, or it can be just a few extra eyelashes.

These extra eyelashes can often be a little shorter and thinner than normal eyelashes. What's special is that these extra eyelashes don't grow where normal eyelashes grow. They come from the inner side of the eyelid, where the Meibomian glands, a type of small gland that provides moisture to our eyes, are located. The main function of these glands is to help keep the eyes moist and not dry.

Distichiasis can be congenital or acquired . Let's talk about that too.

Is this something that happens to many people?

In fact, Distichiasis is not a very common condition . Roughly speaking, it affects about one in 10,000 people . So it's not something that many people have.

What are the symptoms of Distichiasis? Check to see if you have these...

Some people may not have any problems with these extra eyelashes. However, some people may experience various symptoms. Check to see if you have these symptoms:

• Extra eyelashes that are visible from the outside: Sometimes this is the first thing you notice.
• Redness, swelling, itching, or burning of the eyes: This can happen when extra eyelashes rub against the inside of the eye.
• Feeling like there is something in the eye: An annoying sensation, as if a speck of dust has been dropped.
• Frequent occurrence of eyelid boils (styes): These look like painful blisters.
• Photophobia: This means that it is difficult to look at bright lights, such as sunlight or streetlights, and the eyes feel as if they are turning blue.
• Frequent tears flowing from the eyes.
• Frequent eye infections (conjunctivitis): This is also called "red eyes".
• Eye pain.
• Scratches or blemishes on the white of the eye, that is, the transparent part at the front of the eye (cornea): This is something to be concerned about, as it can also affect vision.

Imagine, your friend often says that his eye feels like something is sticking in it, that his eyes are red and teary. He may also say that he has a lot of eyelashes. Maybe he also has this condition called distichiasis.

Why does Distichiasis occur? What are the causes?

The reasons for this can be divided into two main parts.

Causes of Congenital Distichiasis:

This is usually due to a genetic cause . That is, a change in the genes that occurs when a baby is conceived in the womb. Sometimes, when the eye is developing, there is a small change in the cells, and the hair follicles of the eyelashes develop in places where there should be no eyelashes, those places where we mentioned earlier, the Meibomian glands. One of the main genes involved in this is the FOXC2 gene . This gene is involved in the development of not only eyelashes, but also many other things in the body.

Causes of acquired distichiasis:

There are several reasons why this condition may develop later in life. These include:

• Blepharitis: This refers to a long-term inflammation of the eyelid margin.
• Stevens-Johnson syndrome: This is a severe allergic reaction to certain medications or infections, causing blistering and peeling of the skin.
• Ocular cicatricial pemphigoid: This is a rare, immune-system disorder that causes scarring of the eyes.
• Chemical injury to the eye: If something like acid gets in the eye.
• Meibomian gland dysfunction.
• Ocular rosacea: This is a condition that causes symptoms such as inflammation and redness of the eyes, associated with a skin condition.

What is Lymphedema Distichiasis Syndrome?

This is a somewhat unique condition. Lymphedema Distichiasis Syndrome is a genetic condition that is inherited from parents. People with this condition have both lymphedema and distichiasis .

Lymphedema is a condition in which lymph fluid ( lymph) does not flow properly, causing swelling in areas such as the hands and feet, due to a problem with the body's lymphatic system. It's like a clogged water pipe filling with water.

This syndrome is also caused by a defect in the previously mentioned `FOXC2` gene . It has been found that about 94% of people with this syndrome have both lymphedema and distichiasis.

This syndrome can be accompanied by other health problems, such as:

• Drooping eyelids (ptosis).
• Scoliosis.
• Heart diseases (`heart defects`).
• Premature varicose veins.
• Cleft palate.
• Heart rhythm irregularities (arrhythmia).

Is Distichiasis contagious?

No, not at all. Distichiasis is not contagious from person to person. So there is nothing to worry about.

How does a doctor recognize this?

Your doctor, especially an eye care provider, can diagnose this condition during a routine eye exam . They can also see these extra eyelashes clearly when looking at them using a special microscope called a slit-lamp .

Sometimes, there are other eye conditions that can cause symptoms similar to distichiasis. An example is a condition called entropion , which is when the eyelids turn inward, causing the normal eyelashes to rub against the inside of the eye. So, your doctor may need to do more tests to make a definitive diagnosis.

What are the treatments for Distichiasis?

The good news is that most people don't need any special treatment for this . If you have extra eyelashes and they're not causing any problems, you can usually avoid treatment.

But, if there is a problem with the eyes, they need to be treated.

Non-surgical treatment:

Some people can use special contact lenses to reduce eye irritation and inflammation. Alternatively, lubricating eye drops can provide relief.

Additional eyelash removal treatments:

If it's really bothersome, the doctor may decide to remove these extra eyelashes. There are several ways to do this:

• Laser thermal ablation: Laser radiation is used to destroy the hair root.
• Cryotherapy: Uses extreme cold to destroy the hair root.
• Plucking: This can temporarily remove eyelashes, but they will grow back in two to three weeks.
• Electrolysis: The hair root is destroyed by electricity.
• Lid splitting: In this procedure, the doctor cuts a small section of the eyelid and removes the hair follicles. Sometimes this is done in conjunction with cryotherapy or electrolysis, which can reduce the risk of regrowth.

Important: Plucking is only a temporary solution. Other treatments (laser, cryotherapy, electrolysis) may require several sessions to successfully remove all hair.

If you have Lymphedema Distichiasis Syndrome, you may also need other treatments.

Can Distichiasis be prevented?

There is no way to prevent congenital distichiasis, as it is genetic. However, if someone in your family has lymphedema distichiasis syndrome and you are expecting a child, it is worth consulting with a genetic counselor .

Some cases of acquired distichiasis can be prevented. For example, wearing protective equipment when working with chemicals or working with fire can help prevent eye injuries. It is also important to treat any inflammatory eye conditions (such as blepharitis) that may be present.

What can someone with Distichiasis expect?

The condition of a person with distichiasis is generally good . Most of the time it is not a major problem. Sometimes, several treatments are needed to remove the annoying extra eyelashes. Lubricating drops can often reduce eye discomfort.

When should I see a doctor?

Be a little careful about these things:

• If you have persistent itching, redness, or pain in your eyes, don't ignore it. Be sure to see a doctor, especially an ophthalmologist.
• If you already know you have distichiasis, ask your doctor what symptoms you should be especially concerned about and when you should seek emergency care.
• If you have Lymphedema Distichiasis Syndrome, it may also be helpful to learn about genetic counseling or support groups.

What is the difference between Trichiasis and Distichiasis?

These two names are a bit similar, so they can be confusing.

• Trichiasis is when your normal eyelashes turn in the wrong direction, that is, inward into the eye.
• Distichiasis is the presence of an extra row of eyelashes.

What is the difference between Distichiasis and Districhiasis?

It's good to know this too.

• Distichiasis is the presence of two rows of eyelashes.
• Districhiasis is the presence of three rows of eyelashes. This is even rarer.

Finally, things to remember

The word "double eyelid" or distichiasis may sound like a big deal to you. In fact, some people may not have any problems with it. It's not always dangerous.

However, sometimes this can cause problems like eye pain, itching, and redness . It can also lead to frequent eye infections and styes. For some, it can also be associated with a more serious condition like the lymphedema distichiasis syndrome we talked about.

So, if you or your child has any of these symptoms, or notice something strange in your eyelids, don't ignore it. See an eye care provider as soon as possible. The sooner you recognize it, the sooner you can start the necessary treatment and get relief. Your eyes are very valuable!

` Distichiasis, Distichiasis, Eyelashes, Extra Eyelashes, Eye Diseases, Eye Infections, Lymphedema Distichiasis Syndrome