T-cell prolymphocytic leukemia presenting as red eye

T-cell prolymphocytic leukemia (T-PLL) is a rare, highly aggressive, mature T-cell neoplasm. Ocular involvement in T-PLL is very rarely described in the literature. There are only two reports in the literature documenting conjunctival involvement in cases with T-PLL. Conjunctival involvement may be the presenting sign of the disease or rarely signifies the relapse of the disease. We present a case of a 36-year-old Saudi male patient in whom bilateral red eyes were the presenting sign of T-PLL.