Subconjunctival Mascara Deposition

      A 50-year-old woman presented with chronic foreign body sensation in both eyes. She admitted to more than 25 years of heavy mascara use on her lashes with inadequate removal. Eversion of the upper lids revealed multiple darkly pigmented subconjunctival concretions, some eroding through the conjunctival surface (Fig 1A). This was associated with a patchy follicular conjunctivitis and punctate corneal erosions. Histopathological examination of a conjunctival biopsy revealed a chronic inflammatory infiltrate with pigmented macrophages, in keeping with foreign body deposition (Fig 1B).