This patient with proliferative diabetic retinopathy with tractional detachment was noted to have a large asymptomatic silicone oil bubble following multiple prior Avastin injections.
Learning Points:
The older insulin syringe needles provided by compounding pharmacies for the Avastin (bevacizumab) injections were lubricated with silicone.
Many eyes receiving intravitreal Avastin developed small vitreous silicone droplets, although the droplet is unusually large in this patient. Since then, these insulin syringe needles have been discontinued.

