Delhi Journal of Ophthalmology

A Rare Case of Cilia Incarnata Externum

Divya Ramraika,  Bithi Chowdhury,  Anurag Anand 
Department of Ophthalmology, Hindu Rao Hospital, New Delhi, India.

Corresponding Author:

Divya Ramraika (DOMS, DNB)
Senior Resident
Department Of Ophthalmology,
Hindu Rao Hospital, New Delhi, India.

Received: 26-DEC-2021

Accepted: 05-MAY-2022

Published Online: 25-JUN-2022


Cilia incarnata externum is the term used to describe an eyelash that burrows under the skin to the surface. The patient presents due to the appearance of bump. It is asymptomatic and usually requires no treatment but as the patient had cosmetic blemish, a small incision is usually given over the bump and after which cilia is epilated.

Keywords :Cilia Incarnata Externum, Normal Root Of Cilia

A 17-year-old boy presented to outpatient department with  complaint of appearance of bump in his right eye upper lid. Patient has no other symptoms/ history of any trauma. Examination revealed a misdirected eye lash running underneath the skin from the lid margin of the upper right eyelid. Hair was running vertically underneath the skin (Figure 1,2). Vision was 6/6 and there were no symptoms and any other abnormal findings. Hence, we concluded with the diagnosis of cilia incarnata externum. After anesthetizing we had just incised the skin over the bump and cilia was epilated.
Cilia incarnata is the misdirection of eyelashes whereby they grow under the skin through the surface ‘or’ posteriorly to the conjunctival surface instead of emerging normally from the eyelid margin. The lash root is normal in both the conditions.1 The lash grows in the path of least resistance.

Cilia incarnata is caused in adults by mechanical misdirection of either the lash follicles ‘or’ the lashes themselves as a result of some abnormal lid condition.2-5 Previously most of the cases reported were of both females and males.6

  1. Patel BC, Malhotra R. Cilia Incarnata. [Updated 2021 Jul 26]. In : Stat Pearls [Internet]. Treasure Island (FL): Stat Pearls Publishing ;2021 Jan
  2. Bloch FJ. Minor anomalies in position of the eyelashes. Arch Ophthalmol. 1947;37:772-4.
  3. Agarwala HS. Cilium inversum. Am J Ophthalmol. 1963;55:48-9.
  4. Herzog H. Pathologie der Cilien, Z Augenheilkd 1904;12:256.
  5. Belfort R, Ostler HB. Cilia incarnata. Br J Ophthalmol 1976;60:5946.
  6. Ayachit S, Helaiwa KA, et al. Cilium Incarnatum Externum and its management- A rare presentation. Health Sci J. 2022;16(2):914.

Search PubMed for


Ramraika D, Chowdhury B, Anand AA Rare Case of Cilia Incarnata Externum.DJO 2022;32:66


Ramraika D, Chowdhury B, Anand AA Rare Case of Cilia Incarnata Externum.DJO [serial online] 2022[cited 2023 Apr 2];32:66. Available from: