An 81-year-old man was taken to Accident & Emergency after a fall. CT brain imaging demonstrated a well-defined, homogenous, hyperdense mass in the posterior segment of the left eye. Reported as vitreous haemorrhage, an urgent ophthalmological assessment was instigated.Detailed history revealed previous vitreoretinal procedures for multiple retinal detachments. Ophthalmological examination confirmed presence of silicone oil in this eye.The appearance of silicone oil in the eye has become an increasingly prevalent finding given its continued use in complex vitreoretinal procedures since 1962. Clinicians regularly interpreting orbital, facial and brain imaging need to be aware of these imaging appearances to prevent diagnostic confusion.