Bilateral Viral Endophthalmitis as the Presenting Sign of Severe Combined Immunodeficiency

A variety of lesions have been described to simulate retinoblastoma by producing leukokoria. 1 Endophthalmitis can be difficult to differentiate from endophytic retinoblastoma in an infant. We present herein a case of bilateral viral endophthalmitis with massive loculated vitreous cells producing bilateral leukokoria. The ocular diagnosis was critical in the determination of the underlying severe combined immunodeficiency. Report of a Case. A 5-month-old girl was referred for treatment of bilateral intraocular masses believed to be consistent with retinoblastoma. The infant had no medical problems until 1 week before presentation when her parents noted the onset of lethargy, irritability, and meningismus. The infant was treated in a hospital with intravenous antibiotics, but all cultures yielded no growth. Intravenous acyclovir treatment for presumed herpes simplexencephalitis was begun. Ophthalmologic consultation was obtained after the parents reported new onset of strabismus and poor visual behavior. Bilateral leukokoria with large intraocular masses was found,