On examination, her general condition was excellent. Her visual acuity, intraocular pressure, and fundi were all normal. There was no eyelid swelling or erythema. On everting the right upper eyelid, some subconjunctival black deposits were noted (Figure, A). During biopsy, the conjunctiva was incised and multiple black, mulberry-like concretions extruded with mucoid discharge (Figure, B). Topical chloramphenicol, 0.5%, with dexamethasone sodium phosphate, 0.1%, eyedrops were prescribed postoperatively. Histopathological evaluation of these concretions showed large amounts of fungal hyphae (Figure, C and D) with chronic inflammation over the conjunctiva. The diagnosis was subconjunctival mycetoma. Initial culture results for fungal growth were negative, but further evaluation with 28S ribosomal RNA gene sequencing identified the causative organism as E dermatitidis. At subsequent follow-up visits, the patient had complete resolution of symptoms. Topical antifungal treatment was not given as she was asymptomatic and there was no recurrence of mycetoma at month 3 after débridement.