A 12-year-old girl with an unremarkable medical and ocular history was admitted for workup of anemia (hemoglobin, 6.7 g/dL; to convert to grams per liter, multiply by 10) and leukopenia (white blood cell count, 1220 cells/μL; to convert to ×109 cells per liter, multiply by 0.001) with associated symptoms of headache, malaise, recent cough, and fever. Inflammatory markers were elevated with an erythrocyte sedimentation rate greater than 130 mm/h and a C-reactive protein level of 1.48 mg/dL (to convert to milligrams per liter, multiply by 10). The patient noted floaters in her right eye, which prompted an ophthalmology consultation. On bedside examination, her near visual acuity was J1+ (Snellen equivalent, 20/20 OU), and color vision was full in both eyes; the patient’s intraocular pressure, pupils, extraocular movements, and confrontational visual fields were all unremarkable. Dilated examination revealed grade I and II optic disc edema in the right and left eyes, respectively, and peripapillary hemorrhage in the right eye. Optical coherence tomography was obtained 3 days after initial consultation, which confirmed bilateral disc edema, more pronounced in the left eye than the right eye (Figure 1), and 24-2 Humphrey visual field examination in both eyes was normal. Magnetic resonance imaging (MRI) of the brain and orbits with and without contrast and lumbar puncture were obtained, and results showed diffuse signal abnormality in the bone marrow compartment and findings suggestive of papilledema. Magnetic resonance venography did not reveal thrombosis. Opening pressure during lumbar puncture was 37 cm H2O (upper limit of normal, 28 cm H2O); all cerebrospinal fluid (CSF) viral serology test results were negative, and glucose level and red and white blood cell counts were all within normal limits. CSF protein was slightly decreased at 10.4 mg/dL, and CSF cytospin findings were unremarkable.