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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