There are various possibilities for a small white dot like acne inside the eyelid, which may commonly be fatty grains, wheals, chalazion, conjunctival calculi, etc., born inside the eyelid. The patient’s specific symptoms should be differential diagnosis and targeted treatment. 1, fatty grains: mainly due to abnormal eye fat metabolism, can appear inside the eyelids grow a small white dot like acne situation. For the smaller fat particles do not need special treatment, after improving diet and lifestyle habits, will gradually absorb and disappear. Patients with fatty circles under the eyes should avoid spicy and oily foods, and should avoid applying cosmetics that contain more oil around the eyes. In the case of larger fatty grains, surgery is required to remove the grains if necessary. 2. Macrophthalmia: This is mainly due to acute purulent inflammation of the eyelid glands. In the early stages of endophthalmitis, small white dots resembling pimples may appear on the inside of the eyelids. As the disease progresses, it may turn into a yellow pustule, often accompanied by pain and swelling in the eye, and pressure may lead to increased pain. They usually subside on their own. Hot compresses can be used to help relieve the pain, and levofloxacin drops can be used to eliminate the inflammation. If a local abscess develops, it should be treated by surgical drainage; 3. Chalazion: This is a cyst of the lid gland, which is mainly caused by the blockage of the lid gland outlet, resulting in the retention of secretions and chronic irritation of the surrounding tissues. The clinical manifestation is the appearance of small pimple-like white dots inside the eyelids, which may also show symptoms such as local swelling or infection. For the treatment of chalazion, hot compresses, local injection of glucocorticoids and other methods can be used, and if necessary, chalazion excision can be used for treatment; 4, conjunctival stones: also known as eye stones, the clinical manifestation is small, hard, white dot-like hard objects growing inside the eyelids. Patients may experience foreign body sensation, or pain, tearing and other eye irritation. The treatment can be surgically treated to remove the stones, if the stones lead to inflammation of the eye, should also be combined with external erythromycin ointment or oral cephalosporin antibiotics for treatment; 5, other: blockage of the tear sac, eye polyps, etc. can appear inside the eyelids a small white dot like acne, it is recommended that patients go to the hospital ophthalmology in a timely manner, to clarify the cause, the cause of treatment.