A 55-year-old male presented with a chief complaint of irritation in his left eye. The irritation was accompanied by blurred vision, redness, dryness, foreign body sensation, and a burning sensation. The patient reported that in the past he had used artificial tears to relieve the symptoms but stopped several months ago due to increasing and persistent discomfort. Of note, he grew up in Southeast Asia and immigrated to the United States in his twenties. He currently works outside in a landfill but has never consistently worn sunglasses.