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A patient with acute lymphoblastic leukemia who had received CNS sanctuary treatment with cranial X-irradiation and intrathecal methotrexate displayed his first sign of relapse as iritis with malignant hypopyon. Treatment included topical and subconjunctival corticosteroids and local X-irradiation. Leukemic infiltration of the iris may be the first sign of leukemic relapse. Slit-lamp examination should be performed in all leukemic patients with ocular symptoms.
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