A hypopion is an accumulation of pus in the anterior chamber of the eye. Most often, this syndrome is of infectious or inflammatory origin. How to recognize it? What is it due to? What are his treatments? Answers with Dr Nathalie Butel, medical and surgical ophthalmologist.

Hypopion is when you have pus in the anterior segment of the eye.

Two main causes are at the origin of hypopion:

L’endophtalmie 

It is a rare infection that develops inside the eye. This is the first cause to be eliminated because it is extremely serious. This is a medical emergency. “It usually results from the complication of intraocular surgery or general uncontrolled sepsis,” explains the medical and surgical ophthalmologist.  

L’inflammation

It often affects people with Behçet’s disease, an inflammatory vascular disease. When the eye is inflamed, a hypopion is often associated. “In patients suffering from joint diseases, joint flare-ups can be accompanied by eye flare-ups”, explains Dr Nathalie Butel.

Hypopion manifests as a red, painful eye associated with reduced vision. “If it’s large enough, you can see a white level of pus in the eye. When the effusion covers the pupil, a significant visual discomfort can be felt ”, specifies the ophthalmic surgeon.

The diagnosis is clinical. The ophthalmologist notices the presence of a sheet of white fluid in the anterior segment of the eye. A puncture can be done to determine which germ is involved. Then, thanks to the general context, the doctor will be able to confirm the diagnosis and adapt the treatment.

“If the hypopion is linked to an infection, general antibiotic therapy, local antibiotic therapy as well as anti-inflammatory drugs will be administered for at least 15 days. If it is due to inflammation, anti-inflammatory drugs alone will be prescribed. A hypopion is always the sign of a severe disease which testifies to a hyper strong reaction in the eye: either inflammatory or infectious ”, indicates the specialist.