identified it as belonging to the family of dematiaceous fungi. The patient was not immunocompromised. No antifun- gal therapy was administered. The patient did well after excision of the lesion, and there was no recurrence of disease. Fungal isolates from the conjunctival sac are not un- common; they occur in 5% to 10% of normal eyes. 1 Nevertheless, fungal infection is rarer in the conjunctiva than in other ocular structures. In the immunocompetent host, pathogenic fungi, such as Coccidioides immitis and Sporothrix schenckii 2 in Western countries and Rhinosporid- ium seeberi in tropical environments, 3 cause the majority of conjunctival mycosis. In the immunocompromised host or in patients whose conjunctival defenses have been weak- ened by prolonged corticosteroid or antibiotic use, fungal infection occurs more commonly, although it is still rare. 4 Among the fungal infections of the conjunctiva in these two groups, fungi that mimic neoplasms are rare. To our knowledge, there has been one report of a fungal infection of the eyelid that presented as a tumor. 5 The fungus isolated from the patient described was a member of the Dematiaceae family in the order Moniliales. These organisms produce simple conidiophores and have dark brown or black hyphae or spores. This characteristic produced the melanotic hue of this lesion and a close resemblance to conjunctival melanoma, which prompted the excision. Because the overall mortality rate for melanoma of the conjunctiva has been reported to be as high as 26%, 5 it is imperative that the physician be prompt in diagnosing and treating such lesions. When considering a differential diagnosis, the possibility of fungi, although rare, should be entertained. REFERENCES 1. Ando N, Takatori K. Fungal flora of the conjunctival sac. Am J Ophthalmol 1982;94:67–74. 2. Wilson LA, Ajello L. Agents of oculomycosis: fungal infec- tions of the eye. In: Collier L, Balows A, Sussman M, editors. Topley and Wilson’s microbiology and microbial infections, 9th ed. Vol. 4. London: Arnold, 1998:525–567. 3. Shrestha SP, Hennig A, Parija SC. Prevalence of rhinospo- ridiosis of the eye and adnexa in Nepal. Am J Trop Med Hyg 1998;59:231–234. 4. Waddell KM, Sebastian LB, Downing RG. Case reports and small case series: conjunctival cryptococcosis in the acquired immunodeficiency syndrome. Arch Ophthalmol 2000;118: 1452–1453. 5. Folberg R, McLean IW, Zimmerman LE. Malignant mela- noma of the conjunctiva. Hum Pathol 1985;16:136 –143. Intraocular Caterpillar Setae Without Subsequent Vitritis or Iridocyclitis Michael S. Ibarra, MD, Stephen E. Orlin, MD, Bruce R. Saran, MD, Robert P. Liss, MD, and Albert M. Maguire, MD PURPOSE: To report a case of caterpillar setae embedded in the corneal stroma and inferotemporal retina with minimal inflammation. DESIGN: Observational case report. METHODS: A 4-year-old boy developed a red eye after playing with a caterpillar. He was placed on topical tobramycin/dexamethasone and referred for evaluation of embedded setae in his conjunctiva, cornea, iris, and retina. Examination revealed no iridocyclitis or vitritis. RESULTS: Because of the lack of intraocular inflammatory response, no invasive intervention was conducted to remove or destroy the setae and he was tapered off the tobramycin/dexamethasone. At 4-month follow-up he remained asymptomatic with the setae still present in both his cornea and retina. In addition, vitreous mem- branes had formed in the immediate vicinity of the intraretinal setae. CONCLUSION: Intraretinal and corneal setae can be em- bedded with minimal inflammation and can be tolerated without need for surgical intervention. (Am J Ophthal- mol 2002;134:118 –120. © 2002 by Elsevier Science Inc. All rights reserved.) A 4-YEAR-OLD BOY WAS REFERRED FOR EVALUATION OF asymptomatic corneal, iris, and retinal foreign bodies in his right eye. Three weeks prior, the boy had been playing with a caterpillar and subsequently developed a red Accepted for publication March 6, 2002. From the Department of Ophthalmology, Scheie Eye Institute, Uni- versity of Pennsylvania, Philadelphia, Pennsylvania. Inquiries to Michael S. Ibarra, MD, Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, 51 N 39th St, Phila- delphia, PA 19104. FIGURE 2. Periodic acid–Schiff stain of the lesion shows fungal elements (open arrow), surrounding area of chronic inflammation (closed arrows), and conjunctival epithelium (star). AMERICAN JOURNAL OF OPHTHALMOLOGY 118 JULY 2002