title: Bilateral leukemic orbital infiltration presenting as proptosis and narrow-angle glaucoma.
abstract: A 71-year-old man with acute myeloid leukemia presented with bilateral uveal and orbital leukemic infiltration presenting as tense bilateral proptosis, orbital inflammation, and acute-angle closure glaucoma. B-scan ultrasonography revealed uveoscleral thickening and anterior rotation of the ciliary body. Orbital CT and MRI showed bilateral proptosis with streaking of intraconal fat. Temporary pressure lowering occurred after lateral canthotomy and inferior cantholysis. Definitive treatment included systemic chemotherapy and steroids. Over a 2-week period, vision improved and proptosis resolved, and the intraocular pressure returned to normal. The patient died of cerebral complications of his illness after 6 weeks. This is the first reported case of orbital and ocular leukemic infiltration presenting simultaneously as tense proptosis and narrow-angle glaucoma.
authors.affiliation: Cornea and EyePlastic Surgery Unit, Department of Ophthalmology, Western Sydney Eye Hospital, Westmead Hospital Westmead, Australia.
authors.forename: Krishna
authors.initials: K
authors.lastname: Tumuluri
authors.forename: Thomas
authors.initials: T
authors.lastname: Woo
authors.forename: Johnathon
authors.initials: J
authors.lastname: Crowston
authors.forename: Paul R
authors.initials: PR
authors.lastname: Healey
authors.forename: David
authors.initials: D
authors.lastname: Gottlieb
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Maloof
mesh_terms: D000208:Acute Disease; D000368:Aged; D005094:Exophthalmos / Q000175:diagnosis / Q000209:etiology*; D017809:Fatal Outcome; D015812:Glaucoma, Angle-Closure / Q000209:etiology*; D006801:Humans; D007951:Leukemia, Myeloid / Q000150:complications* / Q000175:diagnosis*; D017254:Leukemic Infiltration / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D008297:Male; D009915:Orbit / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography