[Surgery of the eyelid edge--references for general practice]

a) Punctum plasty (eversion of the lacrimal point): This simple method results in a permanently enlarged punctum. A 4-0 silk suture is passed through the vertical part of the canaliculus and the conjunctiva, drawing them together very tightly. The thread falls out after 4-6 weeks. b) Management of trichiasis: Electrolysis of misdirected lashes leads to contraction and renewed misdirection. This disadvantage is avoided by excising the lashes with a 1 mm trephine. The trephine must follow the direction of the lash exactly, so that a complete cylinder including the hair and root can be removed. The resulting small defect heals quickly without contraction.