Recurrent acute myelomonoblastic leukaemia presenting as a red eye

A 68-year-old man was first diagnosed as having acute myelomonoblastic leukaemia on March 17, 1983. After two remissions with treatment, he suffered a further relapse, which caused him to present with a red eye, visual failure, and oedema of the right optic nerve head. Examination of cerebrospinal fluid that was obtained on lumbar puncture demonstrated an acute central nervous system relapse. Computed tomographic scanning led to the diagnosis of leukaemic infiltration of the optic nerve. Systemic and intrathecal treatment by appropriate chemotherapy and by orbital radiotherapy led to resolution of the clinical problem.