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Ophthalmic manifestations of acute leukemia are commonly seen in the choroid and retina; however, conjunctival leukemic lesions are uncommon. We report a case of a 7-month-old female child presented with a fleshy conjunctival mass seen growing in the left eye since 1-month [Figure 1A]. The mass was deep pink in colour, painless and the conjunctiva appeared chemotic [Figure 1B]. There was no proptosis and ophthalmic examination was otherwise normal. The mass was soft-to-firm in consistency and showed prominent corkscrew vessels. A computed tomography scan showed an ill-defined, isodense mass [Figure 2] in the anterior orbit infiltrating the left medial rectus muscle (yellow arrow). An incisional biopsy was planned to ascertain the diagnosis. However, during the preoperative work-up, deranged blood counts prompted a peripheral blood smear to be performed, which showed the presence of blast cells in a background of hypochromic microcytic anaemia. A bone marrow aspirate confirmed the diagnosis of acute myeloid leukemia. The child was initiated on chemotherapy but succumbed to sepsis within 2 months of treatment.

Isolated conjunctival mass presenting as acute myeloid leukemia in an infant