INTRODUCTION: Hypopyon:
Hypopyon is a sterile collection of inflammatory cells in
the inferior angle of the anterior chamber.
Historical Background :
Hypopyon was first considered to lie in the corneal
substance and represented the gravitation of pus between the
lamellae. It was called “onyx” so called from its resemblance to the
root of a finger nail, an appearance which is now called hypopyon
(under, pus). It was thus for a long time thought to be derived from
the cornea, but the sterility of the material and the presence of
pigmented granules in leucocytes demonstrated its origin from iris
and ciliary body.
Hypopyon Uveitis
Hypopyon uveitis refers to certain specific uveitic entities
that are characterized by a sterile collection of leucocytes & variable
amounts of fibrin indicating a severe inflammatory process.
Magnitude of the problem :
The prevalence of uveitic entities that are likely to present with
Hypopyon are in order of their prevalence. Idiopathic uveitis, Anky
losing – spondylitis uveitis, other HLA B 27, uveitis (Reiter’s
syndrome, Inflammatory bowel disease), Behcet’s disease, Herpes
simplex keratouveitis, toxoplasmosis, toxocariasis, Histoplasmosis,
ocular candidiasis, ocular syphilis, Traumatic iridocyclitis, leukemia,
lymphoma (Maquerade syndrome). AIM OF THE STUDY: A prospective descriptive study was undertaken to study all
the cases of uveitis (39 cases) with hypopyon that presented to the
out patient department of Govt. Rajaji Hospital between June
2004 and August 2005 using a standard protocol and compared
with the pattern of hypopyon uveitis in other studies.
MATERIALS AND METHODS: 39 cases of uveitis with hypopyon were included in this
prospective study conducted in our department between June 2004
and August 2005.
INCLUSION CRITERIA:
Any case of uveitis with significant anterior chamber
inflammatory reaction and hypopyon without any primary ocular
infection was included in the study. All the cases of endophthalmitis
with hypopyon were included in the study except that caused by
penetrating or perforating injuries of globe.
EXCLUSION CRITERIA :
Cases with infective corneal pathology or corneal trauma with
hypopyon were excluded from the study thereby excluding
exogenous infective aetiologies.
SUMMARY OF RESULTS
The results of the study are :
HLA B 27 uveitis (28.2%) was the commonest cause of
hypopyon uveitis in our study.
Most cases of hypopyon uveitis were between 30-39 age group
(18 cases) 46.15%
56.14% cases of hypopyon uveitis occurred in males and 43.58
% occurred in females. CONCLUSION: Hypopyon uveitis refers to certain specific uveitic entities that
are characterized by a sterile collection of leukocytes and variable
amount of fibrin indicating of severe inflammatory response. In the
west the common cause of hypopyon uveitis are Behcet’s disease but
in our subpopulation due to varied cultural, hygienic characteristics
the aetiologies of hypopyon uveitis is expected to be different
