Acquired torticollis from an upper eyelid ectopic posterior cilium

An 18-month-old girl was evaluated because of a 2-month history of right head turn with right eyelid redness. Orthoptic evaluation was significant for a large right head turn (left gaze preference) and mild right upper lid swelling. With her abnormal head position there was no strabismus, but it was not possible to coax her into bringing the eyes to primary position or right gaze. There was a recent history of right upper eyelid posterior foreign body removal; recurrent foreign body was suspected. Examination under anesthesia revealed an ectopic eyelash emanating from the right upper eyelid posterior palpebral conjunctiva. After epilation, the abnormal head position resolved and normal ocular motility could be elicited.