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OBJECTIVE We studied a case of severe bilateral Vogt-Koyanagi-Harada syndrome in a 4-year-old boy. METHODS We evaluated the patient's clinical course. RESULTS The patient had severe bilateral, nongranulomatous uveitis and mild uveitic glaucoma. Initial examination and laboratory evaluation failed to provide a diagnosis. The patient subsequently developed areas of vitiligo, alopecia, and poliosis, suggesting the diagnosis of Vogt-Koyanagi-Harada syndrome. This diagnosis was confirmed by the eventual development of bilateral neurosensory retinal detachments. Vision was lost despite aggressive therapy with corticosteroids and chlorambucil. CONCLUSIONS Although uncommon, Vogt-Koyanagi-Harada may affect young children, and may be severe.
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