A systemically healthy and active 3-year-old boy presented to the glaucoma clinic in June 2001 with spontaneous progressive enlargement of the left eye of 2 years' duration. There was no history of prior trauma or surgery. Findings of the examination of right eye were essentially normal. The child had no light perception in the left eye. There was ciliary staphyloma, diffuse corneal edema, dilated fixed pupil, aphakia, and an intraocular pressure of 34 mm Hg by Perkin applanation tonometry under anesthesia. The fundus view was unclear. Ultrasound B-scan showed an increase in the axial length, a clear vitreous cavity, and optic disc cupping (Figure 1A). There was no evidence of subluxation of the crystalline lens or an intraocular mass. An immersion ultrasound B-scan, however, was not done. The glaucoma specialist performed semiconductor diode laser transscleral cyclophotocoagulation to control the intraocular pressure. The child had periodic follow-up at the glaucoma clinic thereafter. The child reported severe pain in the left eye in January 2005 and had evisceration by a pediatric ophthalmologist. A repeated ultrasound B-scan of the eye was not performed before evisceration. Histopathology of the eviscerated tissue showed a malignant round cell tumor with areas of necrosis and calcification, based on which a diagnosis of retinoblastoma was made (Figure 1, B and C), and the child was referred to the ocular oncology service. A computed tomographic scan did not reveal optic nerve invasion or orbital extension (Figure 1D). There was no evidence of systemic metastasis. Results of bone marrow biopsy and cerebrospinal fluid cytology were normal. The child was given high-dose chemotherapy with a combination of carboplatin, vincristine, and etoposide for 3 cycles, followed by eyelid-sparing orbital exenteration (Figure 1E), 4500-cGy (to convert gray to rad, multiply by 100) fractionated external beam radiotherapy to the orbit, and continued chemotherapy for 12 cycles. The child is alive and well, with no local recurrence or systemic metastasis 41 months after completion of treatment (Figure 1F).