Three dimensional ultrasound based coronal “C-scan” imaging technique was used to demonstrate optic nerve extension of retinoblastoma. With a clinical diagnosis of retinoblastoma based on clinical evaluation, ultrasound, and computed radiographic tomography, this patient was treated by primary enucleation. Subsequent histopathological evaluation of the enucleated globe revealed three risk factors for metastatic retinoblastoma (including optic nerve extension).1,2 Both systemic chemotherapy and orbital radiation therapy were employed.3 A 2 year old black female presented with a 1 month history of conjunctival vascular dilation, leucocoria, strabismus, and ptosis involving the right eye. Slit lamp examination revealed a yellow-white tumour filling 70% of the anterior chamber and obscuring view of the posterior segment (fig 1A). Figure 1 (A) External photograph of the anterior segment filled with retinoblastoma. (B) 35 MHz high frequency ultrasound demonstrates tumour cells in both anterior and posterior chambers, and anterior vitreous (arrowhead). High frequency ultrasonography (35 MHz) demonstrated the presence of tumour cells in both the anterior and posterior chambers, as well …