The direction of the eyelashes in normal eyes is to grow outward with the back to the eyeball and not touch the surface of the eye. Common Causes of Ingrown Eyelashes in Infants and Toddlers Ingrown eyelashes in infancy are often caused by congenital entropion of the lid, mostly in the lower lid. Most congenital lid entropion is caused by an inner canthus, overdevelopment of the orbicularis muscle at the lid margin, or underdevelopment of the lid plate. If the infant is fat and has a less than full nasal bridge, this can also cause lower lid entropion. As the eyelashes rub back against the cornea, they can cause damage to the epithelium of the conjunctiva and cornea, resulting in photophobia, tearing, and increased secretions (also known as “eye mucus”). An examination under the naked eye will reveal impingement. When examining the lower lid, the patient should be asked to look down to see if the lashes are touching the cornea. How is entropion treated in infants and children? Because congenital entropion tends to heal itself as the child ages and the nasal bridge develops, and because the eyelashes of infants are soft and delicate, the damage to the ocular surface is relatively minor, there is no urgency to treat it surgically. You can usually use your fingers to pull down on the lower eyelid more often to reduce irritation. However, if the child has significant symptoms of irritation such as photophobia and tearing, and if the eye discharge is high, surgical treatment may be considered. A common surgical procedure is lower lid sutures (this procedure has no surgical incision and uses the pulling force of the sutures to pull the lid margin outward to correct entropion).