This photograph of the left eye was taken 3 months after initiation of treatment. Note the resolution of the pseudo-hypopyon.
Acute leukemia is the most common malignancy in children.
The choroid is the most commonly involved site although this is not always clinically apparrent. Ocular and orbital involvement can manifest as skin infiltration, extraocular muscle palsies, diplopia, proptosis, subconjunctival hemorrhage, sterile ring ulcers, anterior segment necrosis, ciliary body involvement, vitreous leukemic infiltrates, retinal hemorrhages, cotton wool spots, serous retinal detachments, RPE changes, papilledema, or optic nerve infiltration. Hyperviscosity states can manifest as retinal microaneurysms, venous occlusive disease, and retinal neovascularization. Opportunistic infections are common. Complications of therapy include radiation or steroid related cataracts, radiation retinopathy, and chemotherapeutic agent side effects.