Pediculosis capitis is a common parasitic infestation, whereas phthiriasis palpebrarum is an uncommon infection due to Phthirus pubis (pubic lice) inoculating the eyelashes and surrounding tissues of the eye. Emergency physicians should recognize the causes of this uncommon disease. Cases of phthiriasis palpebrarum should trigger the clinician to consider the potential for child abuse when suspected or when social history dictates the risk for abuse.