Hypopyon - Revision history

Danbot: Expand: common causes, slit-lamp evaluation, ophthalmology consult before treatment

2026-03-21T01:45:15Z

Expand: common causes, slit-lamp evaluation, ophthalmology consult before treatment

← Older revision		Revision as of 01:45, 21 March 2026
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	==Background==		==Background==
			*Collection of white blood cells (leukocytic exudate) layering in the anterior chamber of the eye
			*A sign of severe intraocular inflammation — not a diagnosis itself
			*Always indicates significant pathology requiring urgent evaluation
			*'''Most common causes in EM:''' [[corneal ulcer]] (infectious keratitis), severe [[uveitis]], [[endophthalmitis]]

	==Clinical Features==		==Clinical Features==
	*~~A leukocytic exudate, seen in~~ the anterior chamber on [[slit-lamp]] exam		*White or yellow-white layering fluid visible at the dependent (inferior) portion of the anterior chamber
	*~~A sign of inflammation of the anterior uvea and iris~~		*Best visualized on [[slit-lamp]] exam
	*~~The exudate settles at the dependent aspect of the~~ eye ~~due to gravity~~		*Associated findings depend on etiology:
			**[[Eye pain]], photophobia, tearing
			**[[Red eye]], ciliary flush
			**Decreased visual acuity

	==Differential Diagnosis==		==Differential Diagnosis==
	*[[Corneal ulcer]]		*[[Corneal ulcer]] (infectious keratitis) — most common cause; look for corneal infiltrate/opacity
	*[[Uveitis]]		*[[Endophthalmitis]] — post-surgical or post-traumatic; vitreous involvement
	*[[Traumatic iritis]] (severe ~~case~~)		*[[Uveitis]] (anterior) — may be idiopathic or associated with systemic disease
	*[[Behcet's disease]]		*[[Traumatic iritis]] (severe)
	*~~[[Endophthalmitis]]~~		*[[Behcet's disease]] — recurrent hypopyon with oral/genital ulcers
			*Intraocular tumor (rare)

	==Evaluation==		==Evaluation==
			*Visual acuity
			*[[Slit-lamp]] exam: quantify hypopyon height (mm), assess cornea for ulcer/infiltrate, anterior chamber cells/flare
			*Fluorescein staining: rule out [[corneal ulcer]]
			*IOP measurement (may be elevated or low)
			*Dilated fundoscopic exam if endophthalmitis suspected (vitreous haze)
			*'''If corneal ulcer:''' Obtain corneal scrapings for culture before starting antibiotics (ophthalmology)

	==Management==		==Management==
			*'''Emergent ophthalmology consult''' for all cases
			*Do not start treatment until ophthalmology evaluates (may need cultures first)
			*Treatment depends on underlying cause:
			**Infectious keratitis: Fortified topical antibiotics (ophthalmology-directed)
			**Uveitis: Topical steroids + cycloplegic (ophthalmology-directed)
			**Endophthalmitis: Intravitreal antibiotics ± vitrectomy

	==Disposition==		==Disposition==
	*Emergent ~~optho~~ consult		*Emergent ophthalmology consult from ED
			*Most cases require close daily ophthalmology follow-up or admission

	==See Also==		==See Also==
	[[Hyphema]]		*[[Hyphema]]
			*[[Corneal ulcer]]
			*[[Uveitis]]
			*[[Endophthalmitis]]
	~~==External Links==~~


	==References==		==References==
	<references/>		<references/>

	[[Category:Ophthalmology]]		[[Category:Ophthalmology]]

ClaireLewis at 17:03, 5 October 2019

2019-10-05T17:03:32Z

← Older revision		Revision as of 17:03, 5 October 2019
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	==Clinical Features==		==Clinical Features==
	*A leukocytic exudate, seen in the anterior chamber		*A leukocytic exudate, seen in the anterior chamber on [[slit-lamp]] exam
	*A sign of inflammation of the anterior uvea and iris		*A sign of inflammation of the anterior uvea and iris
	*The exudate settles at the dependent aspect of the eye due to gravity		*The exudate settles at the dependent aspect of the eye due to gravity
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	==Differential Diagnosis==		==Differential Diagnosis==
	*[[Corneal ulcer]]		*[[Corneal ulcer]]
	*Behcet's disease		*[[Uveitis]]
			*[[Traumatic iritis]] (severe case)
			*[[Behcet's disease]]
	*[[Endophthalmitis]]		*[[Endophthalmitis]]

Ostermayer at 20:59, 23 May 2019

2019-05-23T20:59:42Z

← Older revision		Revision as of 20:59, 23 May 2019
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	==See Also==		==See Also==
			[[Hyphema]]

Ostermayer: /* References */

2019-05-23T20:54:38Z

References

← Older revision		Revision as of 20:54, 23 May 2019
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	==References==		==References==
	<references/>		<references/>
	[[Ophthalmology]]		[[Category:Ophthalmology]]

Ostermayer: Created page with "==Background== ==Clinical Features== A leukocytic exudate, seen in the anterior chamber A sign of inflammation of the anterior uvea and iris *The exudate settles at the de..."

2019-05-23T20:52:59Z

Created page with "==Background== ==Clinical Features== *A leukocytic exudate, seen in the anterior chamber *A sign of inflammation of the anterior uvea and iris *The exudate settles at the de..."

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