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Trichotillomania: ophthalmic presentation

¹Department of Ophthalmology, Flinders Medical Centre, South Australia.

Australian and New Zealand Journal of Ophthalmology

|February 1, 1995

Summary

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Trichotillomania, a compulsive hair-pulling disorder, can affect eyelids, causing eyelash and eyebrow loss. Early diagnosis and psychiatric referral are crucial for adult patients with this chronic condition.

Area of Science:

Ophthalmology
Psychiatry
Dermatology

Background:

Trichotillomania is a disorder characterized by compulsive hair-pulling.
Eyelid involvement is a less commonly recognized manifestation.
It can lead to significant alopecia of eyelashes and eyebrows.

Observation:

A case study of a 33-year-old woman with chronic trichotillomania involving the eyelids is presented.
The condition began in childhood and persisted into adulthood.
Previous psychiatric interventions were unsuccessful.

Findings:

Diagnosis relies on patient history and slit-lamp examination.
Distinguishing from alopecia areata may require a skin biopsy.
Adult trichotillomania is often chronic and linked to psychiatric comorbidities.

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Implications:

Ophthalmologists should consider trichotillomania in cases of unexplained eyelash and eyebrow alopecia.
Referral to a psychiatrist is recommended for adult patients.
While often benign in childhood, adult trichotillomania necessitates comprehensive management.