Background: The origin of congenitally displaced cilia of the eyelid margin remains a controversial subject.
Methods: Case report with literature review. The clinical, surgical, and histopathologic findings of the current and published cases were used to determine the location of the generative hair bulbs of ectopic cilia.
Results: A 36 year-old man underwent complete excision of a congenital papule containing approximately 25 cilia located in the left lateral upper eyelid. These cilia were separated by 3 mm superior from the normal cilia where there was a miniscule gap. The hair bulbs were located in dense fibrous tissue at the level of the lower dermis but above the orbicularis striated muscle, which during surgery was not defective or colobomatous.
Conclusions: This case supplies additional evidence that ectopic eyelid cilia arise in the eyelid skin and not as has been postulated within metaplastic Meibomian glands of the tarsus.