Factitious Conjunctivitis: A Great Imposter With Compelling Evidence

Factitious illnesses are conditions in which a patient consciously produces symptoms or outward manifestations of ill health. Although uncommon, ophthalmologists should be mindful of the risk of self-inflicted ocular injuries, especially while caring for patients with psychiatric problems. Identifying ocular factitious lesions that only affect the conjunctiva can be difficult. An acceptable index of suspicion, non-judgmental confrontation, and psychiatric consultation promote a successful clinical approach. Making a diagnosis sometimes requires conjunctival biopsies. Focusing on any potential behavioural anomalies and referral to a psychiatrist are also helpful. The authors describe an 16-year-old who self-inoculated rust particles inside the conjunctiva of her right eye, sparing her cornea, in this case report.