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Mirror Hypopyon—Corneal Ulcer With Hypopyon in a Silicone Oil–Filled Eye

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Hyperoleon or inverse hypopyon is caused by emulsified silicone oil from the posterior chamber settling in the anterior chamber.1 The emulsified oil particles being lighter than aqueous, collect superiorly. This patient, a 57-year-old woman, had undergone silicone oil injection elsewhere for a retinal detachment and presented to us with an atrophic, detached retina under the silicone oil. Silicone oil removal was deferred due to poor visual prognosis and to prevent phthisis bulbi. Over time, the silicone oil emulsified, resulting in a hyperoleon in the anterior chamber. Following a foreign body injury to the same eye, she developed a bacterial corneal ulcer with hypopyon, giving a rare presentation of a hypopyon with hyperoleon in the anterior chamber (Figure). Microbiological investigations revealed a Streptococcus pyogenes keratitis sensitive to fluoroquinolones, for which she was treated medically. The corneal ulcer healed within 4 weeks of starting topical antibiotic therapy with complete resolution of the hypopyon.

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Article Information

Corresponding Author: Rashmita Ravisankar, DNB, Cornea and Refractive Services, Aravind Eye Hospital, Cuddalore Main Road, Thavalakuppam, Puducherry, India 605007 (rashmita2992@gmail.com).

Conflict of Interest Disclosures: None reported.

Additional Contributions: We thank the patient for granting permission to publish this information

Reference
1.
Tripathy  K , Sharma  YR .  Inverted hypopyon in the eye.   BMJ Case Rep. 2016;2016:bcr2016214638. doi:10.1136/bcr-2016-214638PubMedGoogle ScholarCrossref
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