Inturned Eyelashes: A Temporary Fix With Adhesive Tape

Troy Brown

May 17, 2012

May 17, 2012 — Inturned upper eyelid eyelashes can cause uncomfortable symptoms and even damage the eye in some cases, but relief may be as close as a roll of adhesive tape.

Jorge G. Camara, MD, a clinical professor of ophthalmology at the University of Hawaii in Honolulu, and colleagues studied a prospective, consecutive, comparative, nonrandomized, interventional case series consisting of 50 patients (100 eyes) with inturned eyelashes and at least 1 of the following symptoms: tearing, itchiness, and/or sensation of a foreign body. The researchers report their results in the May issue of the Archives of Ophthalmology.

Inturned eyelids affect the elderly, as the eyelid margins sometimes turn inward as people age. Other changes can occur at the same time, including eyelid tissue laxity, disinsertion of eyelid retractors, tarsal plate shrinkage, downward displacement resulting from the effects of gravity, and enophthalmos of orbital fat. In addition to foreign body sensation, tearing, and itchiness, eye pain is also a symptom of inturned eyelids.

Chronic lateral conjunctivitis, corneal abrasions, and lateral angular excoriation of the eyelid margin are ophthalmic findings that sometimes accompany inturned upper eyelid lashes. In the most severe cases, the corneal epithelium can become ulcerated from prolonged contact with the eyelashes, causing permanent corneal opacification or blindness.

Surgery not Always Possible

Surgery is the standard treatment for this condition, but it may not always be feasible, as in cases in which an ophthalmic surgeon is not available or surgery cannot be performed for some other reason.

Inturned upper eyelid lashes are very common in Asian people, said Dr. Camara in a telephone interview with Medscape Medical News. "Many of these people in Asia don't have a trained ophthalmologist to take care of their eyes, so I wanted to do a study to see if there was something people could do to at least either temporarily or long-term relieve their symptoms," explained Dr. Camara.

The researchers noted that Asian women often use adhesive tape to create a double upper eyelid fold, and they wondered whether a similar technique might provide temporary symptom relief for patients with inturned upper eyelid lashes.

Patient Selection

They chose 50 consecutive patients who reported having symptomatic, bilaterally inturned upper eyelid eyelashes between August 23, 2010, and January 17, 2011.

Patients were excluded if they had cicatricial entropion, trachoma, or any history of eyelid surgery or trauma to the eyelids or periorbital area. Patients were also excluded if they had a condition (eg, nasolacrimal duct obstruction) that causes the same symptoms.

After measuring the horizontal length of each patient's right eyelid, Transpore tape (3M) was cut into a strip with a vertical height of 5 mm and a horizontal length matching that of the patient's right eyelid. Patients' left eyelids were left untreated and used as controls.

Tape Application

The upper lateral area of excess skin and muscle was lifted, elevating the lax tissue that caused the eyelashes to turn inward. While holding the excess eyelid skin upwardly taut, the tape was firmly placed horizontally across the length of the eyelid about 5 mm above the eyelid margin. This corrected the overriding preseptal orbicularis.

Slit lamp examination confirmed that the inturned eyelashes were no longer in contact with the globe. No other treatments were used for symptom relief.

Patients were given a questionnaire to complete at home once the tape loosened or came off. They were told to assess their symptoms at 3 different times: before and during application and after tape removal.

Patients were told to remove the tape once it no longer held the eyelid up and to record the length of time the tape remained in place. All patients were seen for a follow-up examination 2 weeks after tape placement, and they returned their questionnaires at that time.

The researchers analyzed the data as simple comparative percentages of the 3 symptoms (foreign body sensation, itchiness, and tearing) and their combinations. Efficacy was defined as the absence of symptoms after tape placement and the return of those same symptoms after tape removal.

Symptoms Relieved

Symptoms in the left control eye remained the same throughout the study for all 50 patients. The tape remained in place on the right eyes of patients for a mean duration of 5 days (standard deviation, 1.5 days).

Variance analysis showed a significant difference between the 3 groups (before tape placement, during tape placement, and after tape removal) and the control side (P = .002). There was a significant difference between symptoms before placement and during placement (P = .008) and a significant difference between symptoms during placement and after removal of the tape (P = .007). There was no statistical difference between symptoms before placement and after removal.

"Comparative results indicate an effective decrease of symptoms while the tape was on the eyelid as compared with both before and after adhesive tape placement," the authors write.

"Because surgery is currently the only option available, the use of adhesive tape as described in this article could benefit patients with inturned upper eyelid eyelashes who may be unable to undergo surgery or when no surgeon is available to treat the condition," write the authors. "Furthermore, placement of the tape as described on inturned upper eyelid eyelashes may facilitate preoperative discussion of the benefits of corrective surgery."

Dr. Camara told Medscape Medical News that it is important for physicians to know that the problem is common in elderly Asian patients. "Even if they're not ophthalmologists, my article describes how to use a simple piece of tape in order to keep the lashes from rubbing against the eye," he said.

Useful Maneuver

Tamara R. Fountain, MD, clinical correspondent for the American Academy of Ophthalmology and executive committee member of the American Society of Ophthalmic Plastic and Reconstructive Surgeons, commented on the study in an email interview with Medscape Medical News.

"In most instances, the lashes against the cornea are bothersome to the patient but do not pose a threat to the integrity of the cornea or health of the eye. It is a useful maneuver to improve comfort temporarily," said Dr. Fountain.

The study authors and Dr. Fountain have disclosed no relevant financial relationships.

Arch Ophthalmol. 2012;130:635-638. Full text