Introduction
The anterior chamber of the eye refers to the front portion of the eye seen between the cornea and the iris. The cornea is the clear screen or window present on the front side of the eye, whereas the iris is the colored portion of the eye. Therefore, the eye's anterior chamber generally incorporates the most transparent and superficial parts of the eye. The natural and crystalline lens that focuses on the objects also encompasses the anterior chamber. So, the significant function of the anterior chamber is to focus the light rays that penetrate the eye on the sensitive back layer called the retina.
What Is Hypopyon?
Hypopyon is an eye health condition characterized by the presence of inflammatory cells in the front portion of the eye called the anterior chamber of the eye. So, it is an accumulation or buildup of the white blood cells, forming a whitish layer of fluid in the anterior chamber of the eye, particularly in its lower portion. This condition is generally associated with the redness of the conjunctiva (the thinner mucous membrane lining the inner portion of the eyelids, covering the sclera) and the underlying outermost layer of the sclera called the episclera.
What Are the Causes of Hypopyon?
Hypopyon is also referred to as sterile pus since it results from releasing toxins rather than any invasion of the microbes. A wide range of ailments can contribute to the development of hypopyon. The possible conditions that cause hypopyon include the following.
-
Behcet's Disease: In many cases, the presence of hypopyon is accompanied by Bechet’s disease. This rare disorder results in the inflammation of the tissue and blood vessels throughout one's body. Hence, it is an auto-inflammatory systemic vasculitis (inflammation of the vessels). The chief symptoms of this disease include blurred vision, eye pain, ulcers, painful joints, and ulcers.
-
Acute Anterior Uveitis: Human leukocyte antigen- B27 (HLA-B27) associated with acute anterior uveitis is considered a leading cause of hypopyon in Northern America. Acute anterior uveitis is the inflammatory condition of the strictures present within the anterior portion of the eye. The structures include the iris, the ciliary body (which holds the eye lens in place), and the choroid (the posterior part of the uvea). It is usually characterized by extremely painful and redness of the eye, associated with photophobia and reduced visual acuity. The clinical findings say that nearly half of the acute anterior uveitis cases can be associated with HLA-B27 positive testing. Moreover, a hypopyon is foiled in about 14 percent of such cases.
-
Corneal Ulcer: Hypopyon can be associated with corneal ulcers in many cases. Corneal ulcer refers to a defect or sore in the surface epithelium of the cornea.
-
Syphilis: Syphilis is generally a bacterial infection that spreads by sexual contact. Hypopyon from syphilis is usually rare. Only the complications associated with the untreated disease can result in hypopyon formation in certain cases.
-
Endophthalmitis: This refers to the inflammation of the inner coating layers of the eye. It is crucially an emergency where the tissues lining the inner aspect of the eye become extremely inflamed. Hypopyon is known to be present in 85 percent of the cases of endophthalmitis. Bacterial or fungal infections of the eye can cause it. If left unaddressed, endophthalmitis can result in vision loss.
What Is Hypopyon Corneal Ulcer?
A corneal ulcer is typically an open sore on the cornea. Infection with viruses, bacteria, and fungi can cause corneal ulcers. Sometimes, conditions like eye injury and dry eyes can result in corneal ulceration. The clinical studies suggest that people sleeping with contact lenses are more likely to have the risk of infection and corneal ulcers. Trauma or injury to the cornea disrupting its surface epithelium is considered to be the common cause of hypopyon. Hypopyon corneal ulcers refer to the white fluid accumulation in the anterior chamber associated with corneal ulcers. Here, the pneumococcal strain is the most common causative agent.
What Are the Symptoms of Hypopyon in Corneal Ulcers?
The white exudate formation is the typical clinical manifestation of hypopyon. The fluid settles at the lower part depending upon the aspect of the eye from gravity. The symptoms the person experiences from the formation of the hypopyon are the same as those of the underlying condition that leads to such inflammation.
The symptoms of hypopyon usually include the following.
-
Pain in the eye.
-
Redness of the eye, particularly the conjunctiva.
-
Swollen eyelid.
-
Blurred vision.
-
Epiphora or excessive tearing.
-
Photophobia (discomfort or sensitivity of the eye to brighter light).
How Is Hypopyon Corneal Ulcer Treated?
The management of hypopyon usually requires different treatment options based on the underlying cause of the inflammation. The ophthalmologists perform a comprehensive media Al history evaluation and eye examination to learn about the cause. The doctors treat underlying conditions like corneal ulcers rather than hypopyon itself. A combination of one or more of the following treatment options is usually prescribed while addressing the underlying cause of hypopyon.
-
Antibiotics: Antibiotics are given to fight against bacterial infections in the body, including the eyes. Antibiotic injection is also given through the vitreous (clear gel between the retina and the lens) route.
-
Corticosteroids: This helps reduce the inflammation.
-
Atropine: This is used to dilate the pupil and decrease the muscle spasm, preventing the iris from sticking with the proximal tissues.
-
Surgery: Pars plana vitrectomy is a surgical intervention used to eliminate the vitreous from the eye.
Conclusion
Hypopyon is an eye condition characterized by pus accumulation or build up in the anterior chamber of the eye. Hypopyon corneal ulcer refers to the hypopyon in association with an open sore or ulceration of the cornea. This condition can be intensely painful and might result in significant vision impairment if not treated earlier. It is crucial to seek professional help and get prompt medical treatment if one suspects that one has a hypopyon or corneal ulceration.
