Retinoblastoma presenting as a total hyphema

Retinoblastoma, the most common intraocular malignancy of childhood, presents in many patterns, typically as the easily recognizable signs of leukokoria, glaucoma, strabismus, or vision loss. A small percentage manifest as other more common diagnoses. These more unusual signs can involve any portion of the eye segment, including the orbit and lids, the anterior segment, and the posterior segment, as well as produce systemic illness. This paper deals with the first reported case of retinoblastoma presenting as a spontaneous total hyphema. Accurate diagnosis of similar situations can only be made by means of a high index of suspicion of malignancy and the use of diagnostic tests such as ultrasound and computed axial tomographic scanning.