Hypopyon: Causes, Symptoms, Diagnosis, and Treatment

hypopyon causes and treatment

Hypopyon refers to an inflammation of the anterior chamber of the eyeball, which produces cell infiltration and a collection of pus.

It is a medical condition that consists of an accumulation of fluid between the cornea and the iris.

This pus-like fluid made of white blood cells or leukocytes does not contain or include any bacteria or fungi. In fact, this condition seems to be the result of an immune reaction.

The human body dispatches white blood cells to defend this area against potential pathogens attacking the eye. In those case, the development of Hypopyon is a sign of a systemic illness.

However, sometimes it occurs because of an intraocular inflammatory process resulting from the complication of a penetrating surgery to the eye.

If the condition occurs because of ocular tumors, the fluid would likely consist of neoplastic cells. In such cases, this disease gets called “Pseudohypopyon.”

Hypopyon causes

As Hypopyon is the result of an immune reaction, there are several infections which can make the body to respond in such a way.

Systemic and local conditions that affect the iris and the uvea can lead to several diseases that could induce this immunological response from the body.

Some of such diseases are the following:

Corneal ulcers

They are open sores in the outer layer of the cornea. More often than not, an infection due to bacteria, virus, or fungi, is the cause this condition.

But in some cases, severe dry eye or other ocular disorders, such as corneal dystrophy, can cause it too. Another potential factor that induces the development of this condition is trauma to the eye.

This damage to the cornea can also occur due to foreign bodies or chemicals.

The danger is in the possibility of several pathogens entering into the eye through that open sore or getting foreign bodies lodged inside.

The resultant infection will induce the immune reaction that causes Hypopyon.


It is an infectious disease that primarily impacts the lungs, but it can affect other areas of the body. This infection features the progressive growth of nodules in the tissues.

A bacteria called Mycobacterium tuberculosis is the cause of this condition. They transmitted through the air by droplets generated in the respiratory system of a patient suffering from this disease.

Even though it usually affects the lungs, the same bacteria can cause Uveitis, an ocular disease that can lead to the development of Hypopyon.

Uveitis is an inflammation of the uvea, which is the middle layer of the eye between the sclera and the retina.

Herpes Simplex and Herpes Zoster

Herpes Simplex, more specifically the Type-1 Herpes Simplex, is a virus that often causes a condition which consists of inflammation and small blisters or cold sores on the skin.

However, this very same virus can cause Ocular Herpes, a recurrent viral infection which can result in scarring of the cornea. People often refer to this damage as a cold sore in the eye.

Herpes Zoster refers to the re-awakening of the latent varicella-zoster virus, the same pathogen responsible for chickenpox.

Sometimes, this infection never leaves the body after overcoming chickenpox. Instead, the virus can remain dormant for years until getting reactivated

It features rashes with blisters on the skin that cause considerable pain or discomfort.

Both of these microorganisms can cause Hypopyon as well.

Lyme Disease and Toxocariasis

Lyme Disease, also known as Lyme borreliosis, is a condition that features fever, headache, fatigue, as well as rashes on the skin.

The cause of this infectious disease is a bacteria called Borrelia burgdorferi, which gets transmitted to humans through tick bites.

One the symptoms of this condition are pain and discomfort when the eye gets exposed to light, and ocular inflammation. In fact, this disease can cause damage, as well as swelling of the optic nerve.

This disease can result in the inflammation of the cornea. And in some cases, it can even produce conjunctivitis along with a discharge of pus.

Conjunctivitis consists of the inflammation of the conjunctiva (the outer layer of the eyeball and the inner eyelid).

Toxocariasis is a zoonotic illness. It occurs because of the larvae of the roundworms we find in dogs and cats.

It features increased eosinophilia, an abnormal enlargement of the liver, and inflammation of tissues on other organs.

However, there’s a specific kind of Toxocariasis that negatively impacts the eye: Ocular Toxocariasis.

It occurs when the larva migrates into the eye, causing retinal granuloma and an inflammatory mass in the peripheral retina.

Both of these systemic infections can manifest as a Hypopyon.

Multiple Sclerosis and Psoriatic Arthritis

Multiple Sclerosis is a long-term autoimmune condition which affects the myelin sheath (the protective insulating layer) surrounding nerve cells in the brain and the spinal cord.

The destruction of this protective layer causes nerve damage and disrupts the flow of information through the nerve pathways.

Many patients suffering from this neurodegenerative disease have trouble with their vision. That occurs because this condition damages the optic nerve which connects the eye to the brain.

At least half of the people affected by multiple sclerosis will suffer from blurred eyesight or Optic Neuritis, also known as Retrobulbar Neuritis, which causes pain and temporary vision loss in one eye.

Psoriatic Arthritis often features joint issues and rashes with silvery scales on the skin. Some medical experts believe a malfunction of the immune system causes this condition.

In some cases, psoriatic arthritis is related to eye dryness, eye pain, and conjunctivitis. Some odd occurrences include the intraocular inflammation known as Uveitis.

Sometimes, those patients who have psoriatic arthritis may suffer from psoriasis flare-up.

Psoriasis flare-up occurs around the eyes, cause irritation and makes both eyelids and eyelashes become crusty and get covered in scales.

In a few cases, psoriatic arthritis can cause a rare eye condition called Ectropion, which consists of the lower eyelid turning outward, exposing the inner eyelid.

Such diseases driven by an autoimmune process can potentially cause pus formations in the eye, which leads to Hypopyon.


Hypopyon is not a threat to life or health. This condition is merely the accumulation of pus inside the eyes. That is why most of the symptoms are relatively bearable.

The usual signs of Hypopyon are the following:

  • Constant irritation of the anterior chamber of the eyeball
  • The presence of pus-like fluid between the cornea and the iris, which is visible to the naked eye
  • Redness in the eye
  • Swelling of the eye


A healthcare provider can quickly test if a patient has this condition through physical examination.

Doctors can perform the diagnosis without of particular devices or clinical machines. They can examine the patient with a naked eye, and conclude what’s going on right there and then.

Hypopyon treatment

The medical procedure will depend on the inflammation and the cause of the condition.

Most doctors insist on not eliminating the fluid in its entirety given it’s likely protecting the eye from an underlying infection.

More often than not, the best way to deal with this condition is to cure the disease that triggered the immunological response causing Hypopyon.

In the best cases, Hypopyon gradually disappears without the need for any treatment. However, when the condition persists, healthcare providers prescribe patients with anti-tuberculosis drugs and antibiotics.

If the medications fail to eliminate Hypopyon, medical experts would need to use corneal scraping to discover the exact cause of the condition.

Once doctors understand what’s inducing Hypopyon, they can start with the treatment needed to deal with the condition.

In those odd cases when nothing seems to work, medical experts will have to resort to a therapeutic corneal transplant as the last solution.