# Inverse hypopyon secondary to coughing fit

## TL;DR

A patient experienced sudden vision loss due to a coughing fit causing silicone oil to migrate into the eye, which was successfully treated.

## Contribution

Reports a rare complication of silicone oil tamponade triggered by a coughing fit and its successful management.

## Key findings

- Silicone oil migrated into the anterior chamber, causing a reverse hypopyon after a coughing fit.
- Treatment with anterior chamber washout and aspiration restored visual acuity and normal intraocular pressure.

## Abstract

Silicone oil tamponade is one of the therapeutic methods used in complex retinal detachments caused by inferior and/or posterior dehiscence. However, it can cause complications, in particular, silicone oil migration into the anterior chamber or “invered hypopion”. We here report the case of a patient presenting to the Emergency Department with a sudden decrease in visual acuity in the right eye secondary to a coughing fit. Ophthalmological examination revealed uncorrected visual acuity reduced to perception of hand movements. Intraocular pressure was 27mmHg. The examination of ocular annexes was normal. Slit-lamp examination of the anterior segment revealed emulsified silicone oil suspended in the anterior chamber, hiding half of the pupil and forming ´reverse pseudo-hypopion´ or silicone oil “hyperpion”: the reflection produced by intraocular implant was visible. Fundus was inaccessible. The contralateral eye examination was normal. Treatment was based on anterior chamber washout and aspiration of silicone oil. The patient´s outcome was favorable: visual acuity improved to 3/10 with normal intraocular pressure.