The updated version of this manual combines and updates material contained in three previous manuals on bilamellar tarsal rotation procedure, trabut procedure, and the final assessment of candidate trichiasis surgeons.This manual is designed to provide specific information for trachomatous trichiasis (TT) trainers who are training others to undertake surgery for entropion trachomatous trichiasis. Other approaches are not addressed. The manual is divided into two parts. The first part covers specifics designed for training TT surgeon candidates, and serves as a resource document. The trainer can elect to have trainees read the material directly, use this manual as a guide for creating a training presentation, or use it in other ways to assist in the training. The manual contains both knowledge that should be imparted during training and a description of the skills that need to be developed and assessed during practice and surgery sessions. The second part is designed only for the trainers of the surgeon trainees and covers selection and final assessment of the trainees.