A Pink Conjunctival Lesion.

A 65-year old, farm worker female with a six weeks right eye (RE) discomfort, tearing and progressive eyelid swelling was referred to our clinic. Past ophthalmic and systemic history was uneventful. She presented painless, considerable RE superior eyelid edema, bilateral best-corrected visual acuity of 0.9, normal ocular movement and pupil reflex. Slit lamp examination revealed conjunctival hyperemia, upper perilimbal keratitis and a painless, smooth, pedunculated, salmon-pink, bulbar conjunctival lesion (Fig.1). Ophthalmoscopy and ultrasound examination were unremarkable. At 3 mm distance, a long ‘suture thread like’ was pulled out with a forceps under topical anesthesia. It proved to be a hay straw (Fig.2). Topical treatment (ofloxacin, dexamethasone and carmellose) was started. Two weeks later signs and symptoms have completely subsided. Despite possible macroscopic similarities with other conjunctival tumors, conjunctival lymphoma included, and absence of eye trauma or surgery past story, the clinical context suggested conjunctival pyogenic granuloma / lobular capillary hemangioma related to a foreign body.1-3