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Synthetic fibre granuloma of the conjunctiva, sometimes known as 'teddy bear granuloma', results from granulomatous foreign body reaction of the conjunctiva to synthetic fibres. It is often an incidental finding, most commonly found in children, is unilateral, and occurs in the lower eyelid. We present here, what we believe is the first reported case of synthetic fibre conjunctival granuloma in Hong Kong, together with a review of the condition. An awareness of this clinical entity allows early and accurate diagnosis and early treatment.