The word distichiasis comes from Greek and means "two rows." In this condition, an extra row of eyelash-like hairs (distichia) grows out of the sebaceous gland openings at the edge of the eyelid. Since these misplaced, hard hairs grow toward the eyeball, they cause permanent irritation and damage to the cornea. Another form of distichiasis is ectopic cilia. These are scattered hair follicles that grow out of the inside of the eyelid as individual bristly hairs or as a whole tuft of hair, standing perpendicular to the cornea and causing permanent irritation to the eye. Ectopic cilia are most commonly found on the upper eyelid in dogs and very rarely in cats.
The exact causes of distichiasis are not yet fully understood. In some dogs, distichiasis occurs as a congenital malformation, but it can also happen that the extra eyelashes only develop as the dog gets older. The upper or lower eyelid, or both, can be affected.
Due to the frequent occurrence of the disease in certain breeds, it is assumed that the disease is hereditary to a certain extent. Breeds predisposed to distichiasis and ectopic cilia include Cocker Spaniels, Cavalier King Charles Spaniels, Flat-Coated Retrievers, Tibetan Terriers, Dachshunds, Poodles, Shelties, and Jack Russell Terriers.
The first noticeable symptoms are increased blinking or squinting of the eyelids. Depending on the type, extent, and direction of growth of the distichiae, affected animals show more or less severe chronic irritation of the conjunctiva and cornea, which manifests itself in the form of conjunctival redness, increased tearing, and corneal opacity. If left untreated, the initial irritation can develop into painful corneal damage.
If you notice one or more of the above symptoms in your pet, or if you have noticed them over a longer period of time, consult a veterinarian promptly to avoid possible further damage.
After a general clinical examination and taking a detailed history of the symptoms observed, the attending veterinarian can usually make a preliminary diagnosis. Some of the additional hairs can already be seen with the naked eye. However, particularly fine hairs or those growing on the inside of the eyelid can only be reliably diagnosed with a special magnifying lamp, known as a slit lamp.
The type of treatment depends on the extent and severity of the condition. Distichia that does not cause any discomfort can be left untreated. However, it should be noted that these hairs will fall out and grow back, and may occasionally change direction.
However, if the eye is permanently irritated by the excess eyelashes, they must be removed. Manual plucking with eyelash tweezers only leads to short-term improvement, as the hairs grow back. To remove the hair follicles, surgery under general anesthesia is necessary. Depending on the type and extent of the distichiasis, different surgical procedures can be used.
The fastest and most effective method is electrolytic epilation of the hair with destruction of the hair root, which is successful in many cases. However, the hair follicles can also be destroyed by freezing or laser treatment. In very severe cases, a procedure known as lid splitting is used. This involves cutting out an entire row of distichiasis, including the hair follicles and roots. The risk associated with this surgical method is increased post-operative swelling of the eyelid and scarring. However, the significantly lower risk of recurrence is a positive factor.
The prognosis for distichiasis is favorable after successful surgery. However, it should be noted that, depending on the surgical method used, relapses, i.e., regrowth of the hairs, can occur relatively frequently, meaning that several sessions may be necessary in some cases.
Since the disease is often congenital, prevention is difficult. However, due to its heritability in some breeds, the incidence of the disease can be significantly reduced through breeding measures. Some breeding associations for predisposed breeds have already introduced mandatory breeding approval tests for this purpose.
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