This was a very interesting case because the patient had reported getting something in his eyes months before. He resisted coming in and said it felt better as time went on. However he still feels something is under his eyelid, albeit not painful.
Upon examination he had a foreign body that was tucked into a crevice of this granuloma. I took the foreign body out before taking the photo (I was half tempted to tuck it back in when I realized it would have made a good photo…LOL).
So theoretically what happened is the foreign body was smooth enough to keep him from being miserable, but rough enough for the conjunctiva to form a granuloma around it…a natural reaction of the eye to protect itself. I thought it was interesting. I wish I’d gotten that photo with the foreign body included.