A small white grain growing on the inner side of the lower eyelid is usually caused by conjunctival stones, fat grains and granuloma. 1. Conjunctival stones: Conjunctival stones are mainly caused by bacterial infection of the eye and irritation of the conjunctiva. White granules will appear on the conjunctiva of the patient’s eyelid, manifesting as small white grains on the inner side of the lower eyelid. 2. Fatty granules: Fatty granules are small particles formed due to over-keratinization of hair follicle orifices, obstruction of sebaceous gland ducts, and accumulation of fat under the skin, which leads to small white granules on the inner side of the lower eyelid. 3. Granuloma: Granuloma is an acute suppurative inflammation located in the sebaceous or blepharoplastic glands near the eyelash follicles, commonly known as pinnae. The main manifestations are small boils on the eyelids, mild itching, and redness around the eyes. This is why it can lead to small white grains on the inside of the lower eyelid. The condition of small white grains on the inner side of the lower eyelid may have multiple etiologies, and it is important to note that it cannot be resolved on its own, but should be dealt with in a regular hospital.