Hypopyon
A hypopyon may look alarming, but it is simply a sign of something deeper happening inside the eye. White blood cells collect in the front chamber, usually because of an infection, trauma, or inflammation. The main causes of hypopyon include conditions such as uveitis, keratitis, and endophthalmitis, as well as other inflammatory or infectious triggers.
Some causes, like bacterial or fungal infections, can progress quickly and threaten vision if not treated. Others, such as autoimmune conditions, may point to ongoing health issues that affect more than just the eye.
Definition of Symptom
A hypopyon means white blood cells, often described as pus, settle in the front chamber of the eye. This chamber is the fluid-filled space between the cornea and the iris. The material usually appears as a whitish or yellowish layer at the bottom of the chamber.
This symptom signals severe inflammation or infection inside the eye. It is not a disease itself but a sign of an underlying problem, such as uveitis, corneal ulcer, or trauma. Because the anterior chamber sits in front of the iris, the fluid is usually easy to detect without special equipment.
Key Features of Hypopyon
- Whitish or yellowish pus in the anterior chamber.
- Horizontal fluid line that shifts with gravity.
- Often accompanied by redness, pain, and blurred vision.
This symptom can affect nearby structures. The conjunctiva and sclera may look red or irritated. In severe cases, inflammation can spread deeper and affect the vitreous humour.
Common Associated Hypopyon Symptoms
| Symptom | Description |
|---|---|
| Eye pain | Discomfort or aching in the affected eye. |
| Redness | Inflammation of conjunctiva or sclera. |
| Blurred vision | Reduced clarity due to fluid and swelling. |
| Photophobia | Sensitivity to light. |
Possible Causes/Diseases Condition
White blood cells collect in the front chamber of the eye due to inflammation or infection and cause a hypopyon. It is not a disease itself but a sign of an underlying problem.
- Eye infections often cause hypopyon. These include bacterial infections, viral infections like herpes simplex, and fungal infections such as fungal keratitis. Infections of the cornea, including corneal ulcers, often trigger this reaction.
- Endophthalmitis, a severe infection inside the eye, can lead to vision loss if untreated. Keratitis and iritis may also cause pus to build up in the anterior chamber.
- Autoimmune and inflammatory conditions play a role as well. Uveitis, especially anterior uveitis, is a frequent cause. Behçet’s disease, a systemic inflammatory disorder, can also lead to hypopyon.
Other eye problems linked to hypopyon include glaucoma, hyphema (blood in the front chamber), and complications from trauma. Systemic conditions like leukemia may present with hypopyon as a secondary sign.
| Condition | Type/Category | Possible Link to Hypopyon |
|---|---|---|
| Bacterial infection | Infectious | Triggers inflammation |
| Fungal keratitis | Infectious | Causes corneal damage |
| Endophthalmitis | Infectious | Emergency eye infection |
| Anterior uveitis | Inflammatory | Common inflammatory cause |
| Behçet’s disease | Autoimmune | Leads to recurrent uveitis |
| Leukemia | Systemic disease | May present with hypopyon |
An eye specialist needs to evaluate the condition promptly to identify the exact cause and start treatment.
Other Non-Disease Causes
Not all cases of hypopyon come from infections or chronic eye diseases. Certain events and conditions can trigger inflammation without being tied to a specific illness. These causes often involve the eye’s response to injury, surgery, or immune activity.
- Eye trauma often triggers hypopyon. A direct blow, scratch, or penetrating injury can disturb the anterior chamber, leading to an inflammatory reaction. Even minor trauma may raise the risk if the eye’s natural defenses are weakened.
- Surgical procedures such as cataract surgery or a corneal transplant can also cause hypopyon. While these operations improve vision, they can sometimes trigger inflammation as the eye heals.
- The immune system plays an important role. People with the HLA-B27 protein are more likely to develop inflammation in the eye, even without infection. This link is seen in individuals with certain autoimmune diseases, where the body mistakenly attacks its own tissues.
How It Causes the Symptom
The body sends white blood cells into the front chamber of the eye as part of the immune system’s response to fight infection or control inflammation. The buildup of these cells creates a visible layer of pus. This fluid increases inflammation inside the eye, which can irritate surrounding tissues. This irritation often leads to eye pain, redness, and swelling. The pressure and inflammation may also blur vision.
Light entering an inflamed eye can trigger photophobia or light sensitivity. People may notice discomfort or sharp pain when exposed to bright light. This happens because inflamed tissues become more reactive to visual stimuli. Common symptoms linked to this process include:
- Eye pain that worsens with movement.
- Redness around the cornea.
- Blurred vision from fluid buildup.
- Sensitivity to light due to irritated structures.
Infections, trauma, or autoimmune conditions can all trigger this chain of events. Regardless of the cause, the immune response drives the accumulation of white blood cells, which directly produces the symptom recognized as hypopyon. Urgent evaluation is needed because the underlying inflammation or infection can progress quickly if untreated.
Possible Complications
A hypopyon signals significant inflammation inside the eye. If not treated quickly, this inflammation can damage delicate structures and lead to lasting problems. One of the most concerning risks is vision loss. This can occur if the infection or inflammation spreads deeper into the eye and harms the retina or optic nerve. Even partial damage may cause blurred vision or other visual disturbances.
Another possible outcome is corneal scarring. When the cornea heals from severe inflammation or infection, scar tissue may form, reducing clarity and leading to long-term vision impairment. In some cases, elevated intraocular pressure may develop as inflammation disrupts the eye’s normal fluid drainage. If untreated, this pressure can worsen pain and further threaten vision.
In rare but serious cases, inflammation may contribute to retinal detachment. This condition separates the retina from the back of the eye and requires urgent surgery to prevent permanent blindness. The table below highlights key complications:
| Complication | Possible Impact on Vision |
|---|---|
| Vision loss | Partial or complete loss |
| Blurred vision | Reduced clarity |
| Visual disturbances | Floaters, glare, distortion |
| Corneal scarring | Permanent cloudy vision |
| Retinal detachment | Sudden severe vision loss |
When to Seek Medical Attention
A hypopyon signals serious inflammation inside the eye. Because infection or severe irritation often causes it, you should seek medical care as soon as symptoms appear. Seek urgent attention if you notice:
- Sudden eye pain or redness
- Blurred or reduced vision
- A visible white or yellow layer inside the front of the eye
- Sensitivity to light
An eye examination is the first step in diagnosing hypopyon. The doctor examines the eye with a slit-lamp to view the front chamber and check for inflammation. In some cases, the doctor may use optical coherence tomography to look at deeper structures.
If the doctor suspects an infection, they may give antibiotics or antifungal medicine directly into the eye. For inflammatory causes, the doctor may prescribe steroid drops or medicine to ease pain and prevent complications.
The treatment depends on the cause. Bacterial infections usually need antibiotic injections into the eye, while fungal infections may require antifungal medicine. If the problem is not caused by an infection, steroid drops or other medicine may help.
Untreated hypopyon can threaten vision, so you should not wait for symptoms to improve on their own. Early diagnosis and the right treatment are important for protecting your sight.
