Retrolaminar chiasmal migration of intraocular silicone oil masquerading as subarachnoid hemorrhage on CT head

Silicone oil is used as a long-term treatment agent for intraocular tamponade to repair retinal detachments following vitrectomy. Retrolaminar migration of oil into the optic nerve is a rare complication, with migration into the optic chiasm being even more rare. Following imaging, this entity can be misdiagnosed as acute hemorrhage, aneurysm, or neoplasm on imaging possibly leading to delay of care or unnecessary interventions. We will discuss a case where the imaging findings were thought to represent a small acute subarachnoid hemorrhage possibly related to an aneurysm involving the distal right internal carotid artery.