A 55-year-old man has recurrent corneal abrasions from misdirected lashes along a 4 mm segment of the lower lid margin. The underlying follicles are destroyed and repeated mechanical epilation has failed, with regrowth within weeks. The MOST appropriate definitive treatment is:

• A Repeat forceps epilation every month
• B Full-thickness pentagonal wedge excision of the entire lower lid
• C Argon laser or cryoablation of the lash follicles ✓
• D Lubricating ointment at night

Explanation

Trichiasis with destroyed lash follicles and frequent regrowth after epilation requires destruction of the follicle. Argon laser ablation suits isolated or segmental trichiasis, while cryotherapy suits more extensive involvement; both permanently destroy the follicle. Simple lubrication does not address lash-globe contact, and full-thickness wedge excision is excessive for a short segment and would deform the lid margin. Epilation offers only temporary relief because the follicle remains viable.

Reference: Parsons' Diseases of the Eye, 22nd ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.