Reversed Hypopyon Formed by Emulsified Silicone Oil in the Anterior Chamber

Haziel Rynjah, Assistant Professor; Deepjyoti Baro, Clinical Optometrist

The Assam Royal Global University; Sri Sankaradeva Nethralaya, Assam, India

Figure: Slit-lamp photograph showing a superiorly layered collection of emulsified silicone oil droplets in the anterior chamber.

Image Summary

A 67-year-old male presented with complaints of blurred vision and glare in the right eye for 2 weeks. The patient had a history of pars plana vitrectomy with silicone oil tamponade for retinal detachment repair six months earlier. Best-corrected visual acuity in the affected eye was 6/60 with effort. Slit-lamp examination revealed numerous emulsified silicone oil droplets floating in the anterior chamber, forming a distinct superior meniscus resembling a reversed hypopyon. Mild corneal endothelial deposits and elevated intraocular pressure were also noted. Fundus examination showed an attached retina with retained silicone oil in the vitreous cavity. Based on clinical findings, a diagnosis of reversed hypopyon secondary to migration of emulsified silicone oil into the anterior chamber was made. The patient was advised of silicone oil removal and was managed with topical anti-glaucoma medication pending surgical intervention.