Bird Seed Granuloma

Interpreting Patient Stories

Everything in life is a narrative, and understanding the clinical narrative enhances your clinical skills. This is a crucial part of being a clinician, as it encourages reliance on your own judgment rather than solely on tests. This approach adds meaning to our work.

Let me share the story of a man who came to see me, complaining of a persistent sensation in his right eye. He mentioned that this issue had been present for a few months, had appeared suddenly, and nothing seemed to alleviate it. According to him, an optometrist had already given his eye a clean bill of health. He also noted that he found temporary relief by pulling his eyelid away.

During the consultation, I observed something visible on his right eye. I examined it with the slit lamp and then asked him, “How many birds do you have?” He responded, “Seven.”

Bird seed granuloma
See before and after photos here!

This turned out to be a bird seed granuloma, although it wasn’t a true granuloma. It was just an organic husk from bird seed causing local inflammation. The solution was simple: pick it off with a fine 30G needle, prescribe a short course of topical steroids for a week, and the problem resolves.

We all face time constraints, but learning how to communicate with patients can help you solve most issues. Unfortunately, this skill isn’t taught at university.

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