Phthiriasis palpebrarum is an unusual cause of blepharoconjunctivitis and may 
easily be overlooked because of the failure of physicians to recognize Phthirus 
pubis. We report a case of a 30-year-old woman with persistent itching in the 
left eyelid which was unsuccessfully treated under the diagnosis of allergic 
blepharoconjunctivitis. Careful ophthalmic examination revealed seven bugs with 
multiple red pinpoint excretions and numerous small translucent oval eggs (nits) 
coating the eyelashes. The patient was successfully treated with mechanical 
removal of all the lice and nits from the eyelashes. The specimen proved 
histopathologically to be the Phthirus pubis infestation. The Phthirus pubis 
infestation is usually associated with poor hygiene in overcrowded or 
undeveloped country. However, it may become a notable problem because of 
frequent traveling and commercial activities across the different countries.