To describe endothelial changes associated with emulsified silicone oil. Report of a case. A 77-year-old man had multiple and diffuse clear vesicles on the endothelium of his left eye (LE). The cornea was clear and thin. He had undergone pars plana vitrectomy and intraocular silicone oil injection 5 years before presentation. Specular microscopy revealed numerous small bubbles of emulsified silicone oil and a mild degree of endothelial damage. Emulsified silicone oil can adhere to the endothelium and induce an apparent droplet-like endotheliopathy.

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