Conjunctival foreign bodies are common and mostly harmless. The most frequently identified ones include dust, eyelashes, contact lens and sand. Our case reports an unusual finding in the conjunctival sac.

A 30 year old male patient presented for a regular ophthalmic checkup. The patient did not report any swelling, irritation, itching or redness of the eye. He denied a decrease in the visual acuity. The examination noted a 20/20 uncorrected visual acuity in both eyes with a normal refraction and an intraocular pressure in the normal range.

The left bulbar conjunctiva was clear and quiet. However, a mild swelling and redness of the right conjunctiva was noted. A thoughtful slit lamp examination with a 25x magnification revealed fortuitously the presence of a bug in the conjunctival sac. Later, the patient admitted working in his garden in the previous few days.

The treatment included the insect removal and eye irrigation. No medication was prescribed. The patient was educated on the importance of wearing safety goggles when doing high risk tasks for eye injuries.

This case highlights the importance of a rigorous history and physical examination of patients to diagnose asymptomatic conditions as they can lead to serious complications in the future.