A patient who received silicone oil tamponade 4 months ago presents with a greyish-white collection of small droplets layered in the superior anterior chamber. What is this sign called and what does it indicate?
- A Pseudo-hypopyon, indicating fungal endophthalmitis
- B Inverse hypopyon, indicating silicone oil emulsification ✓
- C Keratic precipitates, indicating granulomatous uveitis
- D Cholesterolosis bulbi, indicating chronic vitreous hemorrhage
Correct answer: B. Inverse hypopyon, indicating silicone oil emulsification
Explanation
Emulsified silicone oil droplets are lighter than aqueous, so they float and accumulate superiorly in the anterior chamber, forming an 'inverse hypopyon'. This signals oil emulsification, which can lead to band keratopathy, glaucoma, and oil migration, and is an indication for oil removal. B true hypopyon settles inferiorly and suggests infection or inflammation, while cholesterol crystals from old hemorrhage also settle dependently.
Reference: Kanski's Clinical Ophthalmology, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.