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A young man in his 20s presented with complaints of persistent redness in the left eye (LE) for over 2 weeks. He was previously managed elsewhere with topical moxifloxacin 0.5% and topical lubricants, without any significant symptomatic relief. On receiving topical corticosteroids, his symptoms worsened, causing a marked increase in redness, watery discharge and pain. There was no history of flu-like symptoms or ulcers elsewhere in the body. At presentation, the LE exhibited diffuse conjunctival congestion, accompanied by multiple localised areas of intense hyperaemia ( figure 1A) and mild upper lid oedema. Slit lamp biomicroscopy further revealed two prominent, elevated nodules in the supero-nasal bulbar conjunctiva near the limbus (figure 1A,B, blue arrows). Sodium fluorescein staining demonstrated multiple conjunctival epithelial defects corresponding to the areas of focal congestion, including staining of the nodular lesion (figure 1C,D). Reduced corneal sensations were also noted. Right eye was within normal limits.