Earlier this summer, one of my eyes started to feel like something was stuck in it. Not the usual dry, gritty Sjogren’s feeling I’ve learned to live with, but one really painful spot that eyedrops couldn’t relieve.
It turned out to be trichiasis, which was an eyelash growing in the wrong direction, back toward the eye instead of away from it. I couldn’t believe such a little thing could cause so much misery.
What is trichiasis?
Trichiasis happens when an eyelash grows inward toward the eyeball rather than outward. In Sjogren’s, chronic eyelid inflammation affects how lashes grow, which makes us more prone to this happening. It’s one more way Sjogren’s can show up to kick you in the pants.
Symptoms may include:
- A foreign body sensation, like something is stuck in your eye
- Irritation concentrated in one specific spot
- Sensitivity to light
- Redness
- No relief from eye drops, no matter how often you use them
- Symptoms that get worse throughout the day
- A watering eye
That combination, especially irritation in one exact spot that eye drops don’t fix, is the biggest clue that this isn’t run of the mill dry eye.
Why it can be easy to miss
This was misdiagnosed as a mild abrasion on my first exam. A thorough eye exam checks your cornea and your general eye health, which are the right things to check first. A single thin lash tucked into the upper lid isn’t always where the exam is aimed, especially early on when symptoms are more mild or could point to a dozen other things.
I dealt with six days of misery before I sought a second opinion with an ophthalmologist, who found the lash and treated it.
How is it treated?
Once trichiasis is identified, there are a few paths forward:
- A provider can pluck the hair out (what my provider did), though this isn’t permanent since the lash tends to grow back (knock on wood – hasn’t grown back for me yet)
- Electrolysis can permanently remove the follicle
- Cryoablation or laser ablation are other options for longer term removal
Which option makes sense depends on how often it recurs and what your provider recommends.
Questions to bring to your own appointment
If you have Sjogren’s and you’re dealing with eye irritation that won’t resolve, these are worth asking:
- Could this be trichiasis?
- Can you examine my lash line carefully?
- Is chronic inflammation affecting my lash growth, and if so, how can we better manage my inflammation?
- How can I have better meibomian gland health?
The advocacy piece
My eye care provider is excellent, and I’m grateful for the care I receive. This isn’t a story about a missed diagnosis or a bad appointment. Sometimes symptoms evolve and new exams are needed.
Advocating for yourself doesn’t always mean pushing back. Sometimes it means being precise. Sometimes it means seeking a second set of eyes (pun very much intended) when six days of misery have gone on for five days too long even after the eye doc gives you lubricating drops.
If something in your body feels wrong in a specific, localized way that general treatment isn’t touching, trust that. Bring the specifics to your appointment. Ask the pointed questions.
Need help on how to better communicate in appointments? Check out my Medical Appointment Toolbox.
This post is based on my personal experience and is intended for informational and educational purposes only. It is not medical advice and should not replace guidance from your own healthcare provider. If you’re experiencing eye irritation, pain, or other symptoms, please consult a qualified medical professional for evaluation and treatment.
Little Engine Patient Advocacy 
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