[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-408013-105":59,"doc-detail-408013-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","factitious-conjunctivitis-a-great-imposter-with-compelling-evidence","Factitious Conjunctivitis: A Great Imposter With Compelling Evidence","","Factitious illnesses involve a patient consciously producing symptoms or visible signs of illness. Ophthalmologists must consider self-inflicted ocular injury, particularly when managing patients with psychiatric conditions. Ocular factitious lesions confined to the conjunctiva can be difficult to recognize, so an approach combining a nonjudgmental clinical stance, an appropriate suspicion index, and psychiatric consultation supports effective management. Diagnosis may require conjunctival biopsy, and attention to behavioural anomalies and referral is often beneficial. The case describes a 16-year-old who self-inoculated rust particles into the right conjunctiva, sparing the cornea.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/factitious-conjunctivitis-a-great-imposter-with-compelling-evidence/408013/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/factitious-conjunctivitis-a-great-imposter-with-compelling-evidence/408013.png","ImageObject",300,407,{"name":92,"@type":93},"Aldword","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":29},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What makes factitious conjunctivitis challenging to diagnose?","Question",{"text":112,"@type":113},"Lesions that primarily affect the conjunctiva can be difficult to identify, especially when symptom severity does not align with objective clinical findings.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How did the authors suspect a factitious cause in this case?",{"text":117,"@type":113},"The patient reported membrane formation and irritation despite limited objective inflammatory signs, and the lesion was localized to the right inferior fornix in a pattern consistent with self-inflicted injury.",{"name":119,"@type":110,"acceptedAnswer":120},"What diagnostic step did the article recommend to confirm the diagnosis?",{"text":121,"@type":113},"Conjunctival biopsy was recommended to establish a definitive diagnosis.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},408013,1790973323,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":29,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":24,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},2336478940917,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Review began 11/11/2025  \nReview ended 11/24/2025  \nPublished 11/30/2025  \n© Copyright 2025  \nMahfooz et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CCBY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98147  \nOpen Access Case Report  \nFactitious Conjunctivitis: A Great Imposter With Compelling Evidence  \nShahrina Mahfooz 1 , Sharah Rahman 2, Tarzia Asma Zafrullah 3 , Rodela Saha 3 , Mohammad Ibn Abdul Malek 4  \n1. Pediatric Ophthalmology and Strabismus, Bangladesh Eye Hospital and Institute, Dhaka, BGD 2. Cornea and Refractive Surgery, Bangladesh Eye Hospital and Institute, Dhaka, BGD 3. Ophthalmology, Lions Eye Institute and Hospital, Dhaka, BGD 4. Ophthalmology, Moorfields Eye Hospital, Bedford, GBR  \nCorresponding author: Sharah Rahman, [dr.sharahrahman@gmail.com](dr.sharahrahman@gmail.com)  \nAbstract  \nFactitious 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 selfinflicted 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, nonjudgmental 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.  \nCategories: Psychiatry, Psychology, Ophthalmology  \nKeywords: conjunctival biopsy, factitious conjunctivitis, pseudomembranous conjunctivitis, psychiatric disorder, self-induced conjunctivitis  \nIntroduction  \nPatients with factitious disorder, also known as Munchausen syndrome, deliberately produce or feign physical or psychological symptoms to assume the sick role and receive medical attention [1] . This condition represents a complex psychiatric challenge in which individuals may harm themselves for subconscious psychological gain rather than external incentives [2] . In ophthalmic practice, factitious ocular disorders are uncommon but well-documented and can present as self-inflicted conjunctivitis, keratitis, corneal ulcers, or even chemical burns [3] . These patients may claim accidental trauma, exaggerate minor symptoms, or intentionally introduce foreign materials into the eye to simulate disease [4] .  \nWe present a case involving a young female patient who deliberately inserted rust particles into the inferior conjunctival fornix of her right eye, resulting in marked hyperemia, discharge, and discomfort mimicking bacterial or chemical conjunctivitis. Careful history-taking and slit-lamp examination, coupled with the absence of objective findings correlating with the severity of symptoms, led to the suspicion of a factitious disorder. This represents, to the best of our knowledge, the first documented instance of rust particleinduced factitious conjunctivitis. Early recognition of such presentations is crucial to prevent unnecessary interventions and to ensure appropriate psychiatric referral and multidisciplinary management [5] .  \nCase Presentation  \nA local ophthalmologist referred a 16-year-old girl as a probable case of unilateral chronic pseudomembranous conjunctivitis unresponsive to topical antibiotics and steroids. At presentation, her unaided visual acuity was 20/20, N6 in both eyes. Examination of the right eye (OD) revealed a reddishbrown discolouration of the lateral inferior fornix, while the left eye appeared normal (Figure 1) .  \nHow to cite this article  \nMahfooz S , Rahman S , Asma Zafrullah T , et al. (November 3","cbCainCus8MUyDoe","https://ap.wps.com/l/cbCainCus8MUyDoe","pdf",2928456,"English","# Abstract\n# Introduction\n# Case Presentation","[{\"question\":\"What makes factitious conjunctivitis challenging to diagnose?\",\"answer\":\"Lesions that primarily affect the conjunctiva can be difficult to identify, especially when symptom severity does not align with objective clinical findings.\"},{\"question\":\"How did the authors suspect a factitious cause in this case?\",\"answer\":\"The patient reported membrane formation and irritation despite limited objective inflammatory signs, and the lesion was localized to the right inferior fornix in a pattern consistent with self-inflicted injury.\"},{\"question\":\"What diagnostic step did the article recommend to confirm the diagnosis?\",\"answer\":\"Conjunctival biopsy was recommended to establish a definitive diagnosis.\"}]","Factitious Conjunctivitis: A Great Imposter With Compelling Evidence | PDF",1790577678,13]