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Subconjunctival Silicone Oil Causing Giant Papillary Conjunctivitis

      A 43-year-old man presented with giant papillary conjunctivitis of the left eye 5 months after retinal detachment repair with silicone oil that was complicated by massive postoperative subconjunctival oil leak. Examination demonstrated clear mobile cysts in Tenon’s capsule for 360 degrees (Fig A), punctate keratopathy, and a giant papillary reaction on the superior tarsal conjunctiva (Fig B). Surgical excision of the cystic lesions was performed. Histopathology demonstrated encysted lipid vacuoles throughout the subconjunctival space with a foreign body reaction (Fig C), consistent with giant papillary conjunctivitis secondary to subconjunctival silicone oil. Following excision, the patient’s symptoms improved, and giant papillary conjunctivitis resolved (Magnified version of Fig A-C is available online at www.aaojournal.org).
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