Sonologic similarity in the differential diagnosis of pediatric neovascular glaucoma

B-mode ultrasonography is widely used in ophthalmology to assess the retina and vitreous when there is a media opacity or very small pupil size, which prevents direct examination of fundus. Unlike other specialties which request radiologists to perform ultrasonography as part of their investigation, we ophthalmologists are able to perform B-scan by our side of the department as and when required. Here, we report a pediatric case in which B-scan happened to be done by the radiologists; further details enhanced with Doppler uptake resulted in a diagnostic dilemma to both ophthalmologists and radiologists. A 10-year-old male child presented with severe pain and redness in the left eye with repeated vomiting. Ocular examination revealed neovascular glaucoma in the left eye with an absent perception of light. Ultrasound B-scan performed by a radiologist showed a linear hyperechoic structure extending from the posterior aspect of the lens to the optic disc with Doppler uptake, which they suggested as a possibility of persistent hyperplastic primary vitreous (PHPV). However, evaluation of previous treatment records revealed an earlier diagnosis of circumscribed choroidal hemangioma with bullous retinal detachment. Evaluation of pediatric neovascular glaucoma thought about as PHPV yielded a surprising diagnosis of choroidal hemangioma with retinal detachment. Hence, the latter needs to be kept in mind, although the radiological findings mislead to diagnose PHPV.