The Effects of Trichiasis on Quality of Life. Trichiasis profoundly affects the quality of life of many with the disease, even some presenting with clinically mild trichiasis. For many, the pain is intense or unbearable and described as a thorn or needle pricking the eye or feeling as if the eye was set on fire. For some, the embarrassment of others seeing their purulent, watery eyes kept them shut in their homes and isolated from the wider community, which was described as “a living death.” Others desired to be socially active but were stigmatized and mocked by family, friends and neighbors. Trichiasis was reported to affect women’s mobility, ability to work, and ability to earn an income, thus rendering them dependent on their families and potentially decreasing their influence in family decision-making. It also prevented women from engaging in financial reciprocity, either lending or borrowing money, and their ability to give alms to fulfill religious obligations thus lowering their social status. The effects of the disease also extended to the entire family and caused social and financial burden, as well as extra work, on other family members. These findings are consistent with and add to understanding gained from anecdotal sources (The Xxxxxx Center, 2009). The findings on loss of independence (specifically, inability to work or move about) are also consistent with the findings of Xxxxxxxx et al.’s case-control study in India (2006), Xxxxx et al.’s study on trichiasis and disability in Tanzania (2001); and Xxxxx et al.’s study in Ethiopia (2011). These studies all conclude that trichiasis in the absence of vision loss is a cause of physical disability, and Xxxxx et al. (2001) postulates that the effect is greater among women. Xxxxxxxx et al. also show that trichiasis patients have poorer psychological health and a poorer environment than controls (cataract and refractive error). However, Xxxxxxxx et al. were unable to show any differences in social relationships between cases and controls. In the present study, many of the women reported incidents where they were mocked, excluded from participation in social activities and withdraw themselves from the community because of fear of stigmatization. It may be that women do not view their disease as causing a change in the relationship itself, or these incidents may have been internalized and be reflected in the poorer scores on psychological health and not in the social relationship category.
