Leukemic relapse presenting as acute unilateral hypopyon in acute lymphocytic leukemia

A 16-year-old girl with acute lymphocytic leukemia in hematologic remission and no evidence of active central nervous system disease had a unilateral hypopyon as her sole site of relapse. She underwent diagnostic paracentesis and was treated with topical corticosteroids, chemotherapy, and radiotherapy to the central nervous system. Ocular involvement of the iris and anterior chamber as the site of primary disease or a relapse is a rare event. The anterior chamber serves as a sanctuary for cancer cells, and treatment protocols, including better anterior chamber prophylaxis, are warranted.