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March 1996

Pathological Case of the Month

Author Affiliations

From the Departments of Ophthalmology and Visual Sciences (Drs Lueder, Matsumoto, and Smith), Pediatrics (Dr Lueder), and Pathology (Dr Smith), Washington University School of Medicine, St Louis (Mo) Children's Hospital.

Arch Pediatr Adolesc Med. 1996;150(3):327-328. doi:10.1001/archpedi.1996.02170280097020

A 4-YEAR-OLD girl was referred for evaluation of a lesion of the left inferior conjunctiva that had been noticed 1 month earlier. Over the 2 days prior to her examination, small amounts of spontaneous hemorrhage had occurred from the lesion. Her medical history was unremarkable.

On examination, she had normal vision in both eyes. A 1×2-mm white lesion was present in the left inferior conjunctival fornix, with hairs appearing to arise from within the lesion (Figure 1). Results of the remainder of her ocular examination were normal.

The patient was examined under anesthesia. The lesion was pedunculated, and the hairs on its surface were easily removed with a cotton-tip swab. The surrounding conjunctiva was erythematous, and follicles were present. With gentle manipulation, the lesion was peeled from the underlying conjunctiva. It appeared to contain synthetic fibers (Figure 2).

Diagnosis and Discussion 

Synthetic Fiber Granuloma ('Teddy Bear Granuloma')  Synthetic fiber granuloma